Individual provider Active NPI

Maria Mackanick, MS

  • Speech-Language Pathologist
  • Indiana, PA
National Provider Identifier
1447005772
Registry record updated Apr 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
120 Irmc Dr
Indiana, PA 15701-3674
Phone
(724) 357-7068
NPI assigned
Apr 19, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X Primary

Addresses

Primary practice location

120 Irmc Dr
Indiana, PA 15701-3674

Mailing address

1760 Roberts St
Nanty Glo, PA 15943-1335
Phone (814) 421-9872

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250728001616 PA Practitioner - Qualified Speech Language Pathologist 9335656172 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana Total Therapy CurrentSince Jun 3, 2025 Accepting new patients
Indiana Total Therapy Inc Speech-Language Pathologist CurrentSince Jun 3, 2025 Accepting new patients

Locations

120 Irmc Dr
Ste 120
Indiana, PA 15701
Phone (724) 357-7068

120 Irmc Dr
Indiana, PA 15701
Phone (724) 357-7068

2010 Shelly Dr
Indiana, PA 15701
Phone (724) 349-2276

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10717/brand/1/csg/1/fhir/r4

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1713484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713484800000",
    "number": "1447005772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1760 ROBERTS ST",
            "city": "NANTY GLO",
            "state": "PA",
            "postal_code": "159431335",
            "telephone_number": "814-421-9872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 IRMC DR",
            "city": "INDIANA",
            "state": "PA",
            "postal_code": "157013674",
            "telephone_number": "724-357-7068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKANICK",
        "first_name": "MARIA",
        "credential": "MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-19",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indiana, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.