Active NPI
Amanda Meredith Kasica, MS CCCSLP
- Speech-Language Pathologist
- Dorchester, MA
National Provider Identifier
1568665214
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 5869
- Practice address
- 105 Victory Road
Dorchester, MA 02122 - Phone
- (617) 371-3010
- Fax
- (617) 371-3044
- NPI assigned
- Jun 8, 2007
- 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 | 5869 | MA | Primary |
Addresses
Primary practice location
105 Victory Road
Dorchester, MA 02122
Mailing address
11 Spruce Street
#2
Watertown, MA 02472
Phone (617) 461-5437
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 Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5869 | MA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1568665214",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 SPRUCE STREET",
"address_2": "#2",
"city": "WATERTOWN",
"state": "MA",
"postal_code": "02472",
"telephone_number": "617-461-5437"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 VICTORY ROAD",
"city": "DORCHESTER",
"state": "MA",
"postal_code": "02122",
"telephone_number": "617-371-3010",
"fax_number": "617-371-3044"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KASICA",
"first_name": "AMANDA",
"middle_name": "MEREDITH",
"credential": "MS CCCSLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MA",
"license": "5869",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dorchester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.