Individual provider Active NPI

Tricia Lee Tillinghast, MA, SLP

  • Speech-Language Pathologist
  • Oswego, NY
National Provider Identifier
1518272178
Registry record updated May 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
58 020360 Issued in NY
Practice address
10 Burkle St
Oswego, NY 13126-3259
Phone
(315) 342-4600
Fax
(315) 342-9599
NPI assigned
Aug 8, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2023

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 020360-01 NY
Speech-Language Pathologist 235Z00000X 58 020360 NY Primary

Addresses

Primary practice location

10 Burkle St
Oswego, NY 13126-3259

Mailing address

703 E Maple Ave
Newark, NY 14513-1845
Phone (315) 690-3712

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230615000824 NY Practitioner - Qualified Speech Language Pathologist 9931567443 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
020360-01NYMDSpeech-Language Pathologist
58 020360NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
State of New York Comptrollers Office CurrentSince Jan 24, 2025 Accepting new patients
315 Therapy for PT, OT and SLP, PLLC Speech-Language Pathologist Past Accepting new patients

Locations

44 Holland Ave
Fl 4
Albany, NY 12208

305 Main St
Binghamton, NY 13905
Phone (607) 729-1295

6007 Fair Lakes Rd
Ste 400
East Syracuse, NY 13057
Phone (315) 234-5730

200 W Dominick St
Rome, NY 13440
Phone (315) 339-6536

Organizations & group practices 3

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": "1281225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684886400000",
    "number": "1518272178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 E MAPLE AVE",
            "city": "NEWARK",
            "state": "NY",
            "postal_code": "145131845",
            "telephone_number": "315-690-3712",
            "fax_number": "315-342-9599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 BURKLE ST",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131263259",
            "telephone_number": "315-342-4600",
            "fax_number": "315-342-9599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLINGHAST",
        "first_name": "TRICIA",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "MA, SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-08",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "020360-01",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "58 020360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oswego, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2023; 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.