Active NPI
Geneva Mayne
- Speech-Language Pathologist
- New Rochelle, NY
National Provider Identifier
1497313860
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 025447-1
- Practice address
- 515 North Ave
New Rochelle, NY 10801-3405 - Phone
- (914) 576-4300
- NPI assigned
- May 31, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 025447-1 | NY | Primary |
Addresses
Primary practice location
515 North Ave
New Rochelle, NY 10801-3405
Mailing address
81 Pondfield Rd Ste D141
Bronxville, NY 10708-3818
Phone (914) 486-5939
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 05936645 | Medicaid | NY |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 025447-1 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1592697600000",
"number": "1497313860",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "81 PONDFIELD RD STE D141",
"city": "BRONXVILLE",
"state": "NY",
"postal_code": "107083818",
"telephone_number": "914-486-5939"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "515 NORTH AVE",
"city": "NEW ROCHELLE",
"state": "NY",
"postal_code": "108013405",
"telephone_number": "914-576-4300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAYNE",
"first_name": "GENEVA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-05-31",
"last_updated": "2020-06-21",
"certification_date": "2020-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "025447-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "05936645",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in New Rochelle, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 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.