Individual provider Active NPI

Alexandra Anita Sibilla, MS CF TSSLD SLP

  • Speech-Language Pathologist
  • New Windsor, NY
National Provider Identifier
1477026060
Registry record updated Jul 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
028827 Issued in NY
Practice address
815 Blooming Grove Tpke
New Windsor, NY 12553-8135
Phone
(845) 527-2089
NPI assigned
Jan 7, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2019

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 028827 NY Primary

Addresses

Primary practice location

815 Blooming Grove Tpke
New Windsor, NY 12553-8135

Mailing address

815 Blooming Grove Tpke
New Windsor, NY 12553-8135

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190717002424 NY Practitioner - Qualified Speech Language Pathologist 2567797228 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehabilitation Physical Therapy Services LLC Speech-Language Pathologist CurrentSince Jul 1, 2019 Accepting new patients

Locations

7 Carnegie Plz
Cherry Hill, NJ 08003

1415 Richmond Ave
Staten Island, NY 10314
Phone (212) 475-5540

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": "1546819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562112000000",
    "number": "1477026060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 BLOOMING GROVE TPKE",
            "city": "NEW WINDSOR",
            "state": "NY",
            "postal_code": "125538135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 BLOOMING GROVE TPKE",
            "city": "NEW WINDSOR",
            "state": "NY",
            "postal_code": "125538135",
            "telephone_number": "845-527-2089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIBILLA",
        "first_name": "ALEXANDRA",
        "middle_name": "ANITA",
        "credential": "MS CF TSSLD SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-07",
        "last_updated": "2019-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "028827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Windsor, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2019; 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.