Individual provider Active NPI

Elena Kabzan-Vaynman, M.S., CCC/SLP

  • Speech-Language Pathologist
  • Brooklyn, NY
National Provider Identifier
1508008244
Registry record updated Jun 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
009090 Issued in NY
Practice address
2760 Whitman Dr
Brooklyn, NY 11234-6809
Phone
(917) 428-6059
NPI assigned
Mar 26, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 009090 FL
Speech-Language Pathologist 235Z00000X 009090 NY Primary

Addresses

Primary practice location

2760 Whitman Dr
Brooklyn, NY 11234-6809

Mailing address

8850 Edgewater PL
Parkland, FL 33076-4572
Phone (917) 428-6059

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250630001819 FL Practitioner - Qualified Speech Language Pathologist 0547493298 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Supreme Speech Therapy IncGroup PAC ID 0345762746, 4 clinicians

Practice addresses (Care Compare)

Hollywood, FL 33021
Phone (954) 483-7859

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
009090FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Supreme Speech Therapy Inc Speech-Language Pathologist CurrentSince Apr 15, 2025 Accepting new patients
Elena Kabzancccslp, Inc. Speech-Language Pathologist Current 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": "1238025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750809600000",
    "number": "1508008244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8850 EDGEWATER PL",
            "city": "PARKLAND",
            "state": "FL",
            "postal_code": "330764572",
            "telephone_number": "917-428-6059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2760 WHITMAN DR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112346809",
            "telephone_number": "917-428-6059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KABZAN-VAYNMAN",
        "first_name": "ELENA",
        "name_prefix": "Ms.",
        "credential": "M.S., CCC/SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-26",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "009090",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "009090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.