Individual provider Active NPI

Laura Gentile, SLP

  • Speech-Language Pathologist
  • Egg Harbor Township, NJ
National Provider Identifier
1457062614
Registry record updated Dec 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
41YS00706500 Issued in NJ
Practice address
103 Crystal Lake Dr
Egg Harbor Township, NJ 08234-8705
Phone
(609) 204-5953
NPI assigned
Dec 8, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2022

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 41YS00706500 NJ Primary

Addresses

Primary practice location

103 Crystal Lake Dr
Egg Harbor Township, NJ 08234-8705

Mailing address

103 Crystal Lake Dr
Egg Harbor Township, NJ 08234-8705
Phone (609) 204-5953

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230113002482 NJ Practitioner - Qualified Speech Language Pathologist 6002287851 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atlantic Speech and Swallowing Center LLCGroup PAC ID 4284005034, 2 clinicians

Practice addresses (Care Compare)

6712 Washington Ave
Suite 204
Egg Harbor Township, NJ 08234-1999
Phone (609) 798-1518

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Atlantic Speech and Swallowing Center, LLC Speech-Language Pathologist CurrentSince Mar 6, 2023 Accepting new patients

Locations

6712 Washington Ave
Ste 204
Egg Hbr Twp, NJ 08234
Phone (609) 412-3561

Organizations & group practices 1

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": "1670457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671062400000",
    "number": "1457062614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 CRYSTAL LAKE DR",
            "city": "EGG HARBOR TOWNSHIP",
            "state": "NJ",
            "postal_code": "082348705",
            "telephone_number": "609-204-5953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 CRYSTAL LAKE DR",
            "city": "EGG HARBOR TOWNSHIP",
            "state": "NJ",
            "postal_code": "082348705",
            "telephone_number": "609-204-5953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENTILE",
        "first_name": "LAURA",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-08",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS00706500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Egg Harbor Township, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.