Individual provider Active NPI

Tanika Peart

  • Speech-Language Pathologist
  • Freehold, NJ
National Provider Identifier
1508219627
Registry record updated Jul 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
024766-1 Issued in NY
Practice address
152 Derby Dr
Freehold, NJ 07728-2767
Phone
(908) 692-0146
NPI assigned
Jul 14, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2016

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 024766-1 NY Primary

Addresses

Primary practice location

152 Derby Dr
Freehold, NJ 07728-2767

Mailing address

152 Derby Dr
Freehold, NJ 07728-2767

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170822001908 NY Practitioner - Qualified Speech Language Pathologist 0244502557 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
024766NYMDClinical Psychologist
024766-1NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
United Cerebral Palsy of New York City Inc CurrentSince Jul 10, 2017 Accepting new patients

Locations

175 Lawrence Ave
Brooklyn, NY 11230
Phone (718) 436-7600

80 Maiden Ln
Fl 12
New York, NY 10038

Interoperability endpoints

  • Direct secure messaging: tanika.peart.p2@direct.ucpnyc.nextgenshare.com

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": "1468454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468454400000",
    "number": "1508219627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 DERBY DR",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077282767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 DERBY DR",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077282767",
            "telephone_number": "908-692-0146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEART",
        "first_name": "TANIKA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-14",
        "last_updated": "2016-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "024766-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freehold, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2016; 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.