Individual provider Active NPI

Cheryl Irene Demetros, MA,CCC-SLP

  • Speech-Language Pathologist
  • Beacon, NY
National Provider Identifier
1487809117
Registry record updated Jul 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
003916-1 Issued in NY
Practice address
15 Hastings Dr
Beacon, NY 12508-2056
Phone
(845) 838-4436
Fax
(845) 838-8883
NPI assigned
Nov 21, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 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 003916-1 NY Primary

Addresses

Primary practice location

15 Hastings Dr
Beacon, NY 12508-2056

Mailing address

241 North Road
Suite 400a
Poughkeepsie, NY 12601
Phone (845) 431-8803

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
003916-1NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mid Hudson Valley Early Education Center CurrentSince Jul 31, 2022 Accepting new patients

Locations

241 North Rd
Ste 400A
Poughkeepsie, NY 12601
Phone (845) 431-8803

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": "1227225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658880000000",
    "number": "1487809117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "241 NORTH ROAD",
            "address_2": "SUITE 400A",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "12601",
            "telephone_number": "845-431-8803",
            "fax_number": "845-483-5688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 HASTINGS DR",
            "city": "BEACON",
            "state": "NY",
            "postal_code": "125082056",
            "telephone_number": "845-838-4436",
            "fax_number": "845-838-8883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMETROS",
        "first_name": "CHERYL",
        "middle_name": "IRENE",
        "name_prefix": "Mrs.",
        "credential": "MA,CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-21",
        "last_updated": "2022-07-27",
        "certification_date": "2022-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "003916-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beacon, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2022; 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.