Individual provider Active NPI

Jessica Pelizari

  • Speech-Language Pathologist
  • Averill Park, NY
National Provider Identifier
1457766396
Registry record updated Mar 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
024798 Issued in NY
Practice address
2398 Ny Highway 43
Averill Park, NY 12018-4531
Phone
(215) 954-9074
NPI assigned
Jun 30, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 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 024798 NY Primary

Addresses

Primary practice location

2398 Ny Highway 43
Averill Park, NY 12018-4531

Mailing address

PO Box 906
Averill Park, NY 12018-0906
Phone (215) 954-9074

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
024798NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Rosebridge Speech Therapy, PLLC Speech-Language Pathologist CurrentSince Aug 25, 2024 Accepting new patients

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": "1404086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711152000000",
    "number": "1457766396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 906",
            "city": "AVERILL PARK",
            "state": "NY",
            "postal_code": "120180906",
            "telephone_number": "215-954-9074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2398 NY HIGHWAY 43",
            "city": "AVERILL PARK",
            "state": "NY",
            "postal_code": "120184531",
            "telephone_number": "215-954-9074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELIZARI",
        "first_name": "JESSICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-30",
        "last_updated": "2024-03-23",
        "certification_date": "2024-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "024798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Averill Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.