Individual provider Active NPI

Rene Tara Wazowicz

  • Speech-Language Pathologist
  • Rochester, NY
National Provider Identifier
1467645630
Registry record updated Jan 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
016387 Issued in NY
Practice address
1000 Elmwood Ave
Suite 400
Rochester, NY 14620-3042
Phone
(585) 271-0680
NPI assigned
Aug 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2016

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 016387 NY Primary

Addresses

Primary practice location

1000 Elmwood Ave
Suite 400
Rochester, NY 14620-3042

Mailing address

52 Falcon TRL
Pittsford, NY 14534-2456
Phone (585) 367-7643

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
016387NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Rochester Hearing and Speech Center Past Accepting new patients
Hearing and Speech Center of Rochester Inc. Speech-Language Pathologist PastSince Apr 27, 2017 Accepting new patients

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": "1187740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452124800000",
    "number": "1467645630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 FALCON TRL",
            "city": "PITTSFORD",
            "state": "NY",
            "postal_code": "145342456",
            "telephone_number": "585-367-7643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 ELMWOOD AVE",
            "address_2": "SUITE 400",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146203042",
            "telephone_number": "585-271-0680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAZOWICZ",
        "first_name": "RENE",
        "middle_name": "TARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-22",
        "last_updated": "2016-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "016387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2016; 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.