Individual provider Active NPI

Alyssa Matriccino, CCC-SLP

  • Speech-Language Pathologist
  • Hollywood, FL
National Provider Identifier
1548613656
Registry record updated Oct 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA15998 Issued in FL
Practice address
1 Oakwood Blvd
Suit 130
Hollywood, FL 33020-1956
Phone
(954) 925-3844
NPI assigned
Jul 13, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2022

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 SZ 7581 FL
Speech-Language Pathologist 235Z00000X SA15998 FL Primary

Addresses

Primary practice location

1 Oakwood Blvd
Suit 130
Hollywood, FL 33020-1956

Mailing address

1 Oakwood Blvd
Suit 130
Hollywood, FL 33020-1956

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

LicenseStateTypeSpecialty
SA15998FLMDSpeech-Language Pathologist
SZ 7581FLMDSpeech-Language Pathologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1468368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666051200000",
    "number": "1548613656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 OAKWOOD BLVD",
            "address_2": "SUIT 130",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330201956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 OAKWOOD BLVD",
            "address_2": "SUIT 130",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330201956",
            "telephone_number": "954-925-3844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATRICCINO",
        "first_name": "ALYSSA",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-13",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SZ 7581",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA15998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.