Individual provider Active NPI

Andrea Nicole Weaver

  • Speech-Language Pathologist
  • Belmar, NJ
National Provider Identifier
1558695536
Registry record updated Jan 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
41YS00627300 Issued in NJ
Practice address
508 10TH Ave
Belmar, NJ 07719-2317
Phone
(732) 910-9196
NPI assigned
Sep 24, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2017

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 41YS00627300 NJ Primary

Addresses

Primary practice location

508 10TH Ave
Belmar, NJ 07719-2317

Mailing address

508 10TH Ave
Belmar, NJ 07719-2317
Phone (732) 910-9196

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170201000350 NJ Practitioner - Qualified Speech Language Pathologist 2769764554 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Link Home Services of NJ LLCGroup PAC ID 9133551765, 45 clinicians
Coastal Home Rehabilitation, LLCGroup PAC ID 0345418646, 50 clinicians

Practice addresses (Care Compare)

Englewood Cliffs, NJ 07632
Phone (718) 650-6230

508 10TH Ave
Belmar, NJ 07719-2317
Phone (908) 670-6695

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Home Rehabilitation, LLC CurrentSince Jan 2, 2017 Accepting new patients
Link Home Services of NJ LLC CurrentSince Oct 1, 2024 Accepting new patients

Locations

180 Sylvan Ave
Ste 401
Englewood Cliffs, NJ 07632
Phone (347) 841-8943

516 Sylvan Ave
Englewood Cliffs, NJ 07632

Organizations & group practices 2

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": "1253750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483315200000",
    "number": "1558695536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 10TH AVE",
            "city": "BELMAR",
            "state": "NJ",
            "postal_code": "077192317",
            "telephone_number": "732-910-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 10TH AVE",
            "city": "BELMAR",
            "state": "NJ",
            "postal_code": "077192317",
            "telephone_number": "732-910-9196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "ANDREA",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-24",
        "last_updated": "2017-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS00627300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belmar, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.