Active NPI
Tracie Dawn Donzis, MA, CCC, SLP
- Speech-Language Pathologist
- Roslyn, NY
National Provider Identifier
1528379963
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 019167-1
- Practice address
- 110 Ash Dr
Roslyn, NY 11576-2208 - Phone
- (516) 996-9618
- NPI assigned
- Jun 30, 2010
- 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 | 019167-1 | NY | Primary |
Addresses
Primary practice location
110 Ash Dr
Roslyn, NY 11576-2208
Mailing address
110 Ash Dr
Roslyn, NY 11576-2208
Phone (516) 996-9618
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03833130 | 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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019167-1 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277856000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484697600000",
"number": "1528379963",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 ASH DR",
"city": "ROSLYN",
"state": "NY",
"postal_code": "115762208",
"telephone_number": "516-996-9618"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 ASH DR",
"city": "ROSLYN",
"state": "NY",
"postal_code": "115762208",
"telephone_number": "516-996-9618"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DONZIS",
"first_name": "TRACIE",
"middle_name": "DAWN",
"credential": "MA, CCC, SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-06-30",
"last_updated": "2017-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "019167-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03833130",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Roslyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.