Jessica Marie D'Agostino

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

146012833 Issued in IL

Practice address

590 Fishers Station Dr
Suite 130
Victor, NY 14564-9744

Phone

(585) 924-7207

Fax

(585) 924-7049

NPI assigned

Sep 18, 2012

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Western New York Speech-Language Pathology, OT, and PT Consultants

  • Early Intervention Provider Agency
  • Victor, NY
  • NPI 1386812550

  Speech-Language Pathologist

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1347926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594080000000",
    "number": "1497005425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16931 GRISSOM DR",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604772698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 FISHERS STATION DR",
            "address_2": "SUITE 130",
            "city": "VICTOR",
            "state": "NY",
            "postal_code": "145649744",
            "telephone_number": "585-924-7207",
            "fax_number": "585-924-7049"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "403 N 4th St",
            "address_purpose": "LOCATION",
            "city": "Danforth",
            "state": "IL",
            "postal_code": "609305800",
            "country_code": "US",
            "telephone_number": "815-269-2970",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "D'AGOSTINO",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-18",
        "last_updated": "2020-07-07",
        "certification_date": "2020-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "022538",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146012833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julia Beth Croft, MSPT
• Ian Crosby, LCSW
• Kelly Crosby
• Erin Cummings
• CVS Albany LLC
• Sarah K D'Agostino, M.S.
• Jorich Dalistan
• Erin Daly
• Jacqueline Dantonio
• Jenna Marie Davies

• Speech-Language Pathologist in Victor, NY
• Providers in Victor, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2020; 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.