Individual provider Active NPI

Dwayne Sailsman

  • Speech-Language Pathologist
  • Brooklyn, NY
National Provider Identifier
1578892923
Registry record updated Dec 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
019716-1 Issued in NY
Practice address
530 E 81St St
Brooklyn, NY 11236-3117
Phone
(917) 912-1112
NPI assigned
Dec 14, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2009

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 019716-1 NY Primary

Addresses

Primary practice location

530 E 81St St
Brooklyn, NY 11236-3117

Mailing address

530 E 81St St
Brooklyn, NY 11236-3117

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
019716-1NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1260748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260748800000",
    "number": "1578892923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 E 81ST ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112363117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 E 81ST ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112363117",
            "telephone_number": "917-912-1112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAILSMAN",
        "first_name": "DWAYNE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-12-14",
        "last_updated": "2009-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "019716-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2009; 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.