Active NPI
Pamela Ruth Tillia
- Speech-Language Pathologist
- Buffalo, NY
National Provider Identifier
1518135508
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 003536-1
- Practice address
- 51 Saint Johns Parkside St
Buffalo, NY 14210-2515 - Phone
- (716) 828-9560
- NPI assigned
- Feb 13, 2008
- Sex
- Female
- Sole proprietor
- No
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 | 003536-1 | NY | Primary |
Addresses
Primary practice location
51 Saint Johns Parkside St
Buffalo, NY 14210-2515
Mailing address
51 Saint Johns Parkside St
Buffalo, NY 14210-2515
Phone (716) 828-9560
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 |
|---|---|---|---|
| 003536-1 | NY | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baker Hall Inc | Past | Accepting new patients |
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.
-
- Early Intervention Provider Agency
- Lackawanna, NY
- NPI 1700013927
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1202860800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1202860800000",
"number": "1518135508",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "51 SAINT JOHNS PARKSIDE ST",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142102515",
"telephone_number": "716-828-9560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "51 SAINT JOHNS PARKSIDE ST",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142102515",
"telephone_number": "716-828-9560"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TILLIA",
"first_name": "PAMELA",
"middle_name": "RUTH",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-02-13",
"last_updated": "2008-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "003536-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Buffalo, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.