Individual provider Active NPI

Rebecca Leigh Walsh

  • Speech-Language Pathologist
  • Astoria, NY
National Provider Identifier
1598074023
Registry record updated Oct 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
020137-1 Issued in NY
Practice address
2803 34TH St Apt 2F
Astoria, NY 11103-5003
Phone
(718) 939-8700
NPI assigned
Oct 1, 2010
Last updated
Oct 1, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2010

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 020137-1 NY Primary

Addresses

Primary practice location

2803 34TH St Apt 2F
Astoria, NY 11103-5003

Mailing address

2803 34TH St Apt 2F
Astoria, NY 11103-5003
Phone (718) 939-8700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120228000093 NY Practitioner - Qualified Speech Language Pathologist 8729246434 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Mercy College, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Shield of David, Inc.Group PAC ID 2264472026, 15 clinicians
Lifespire, Inc.Group PAC ID 5496644015, 11 clinicians

Practice addresses (Care Compare)

14461 Roosevelt Ave
Flushing, NY 11354-6252
Phone 71893987001311

16210 Jamaica Ave
Suite 7
Jamaica, NY 11432-4923
Phone (718) 454-2700

21301 Northern Blvd
FL 2
Bayside, NY 11361-2978
Phone (718) 721-5444

3909 214TH PL
Bayside, NY 11361-2123
Phone 71822957572289

The Shield Institute
Flushing, NY 11354-6252

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
020137-1NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespire, Inc. CurrentSince Oct 21, 2018 Accepting new patients
The Shield of David, Inc. CurrentSince Jan 22, 2012 Accepting new patients
Lifespire, Inc. CurrentSince Oct 21, 2018 Accepting new patients

Locations

21301 Northern Blvd
Fl 2
Bayside, NY 11361
Phone (718) 721-5444

14461 Roosevelt Ave
Flushing, NY 11354
Phone (718) 886-1534

3909 214th Pl
Flushing, NY 11361
Phone (718) 229-5757

16210 Jamaica Ave
Ste 7
Jamaica, NY 11432
Phone (718) 454-2700

159 E 125th St
Fl 2
New York, NY 10035
Phone (212) 360-5600

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1285891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285891200000",
    "number": "1598074023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2803 34TH ST APT 2F",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111035003",
            "telephone_number": "718-939-8700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2803 34TH ST APT 2F",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111035003",
            "telephone_number": "718-939-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSH",
        "first_name": "REBECCA",
        "middle_name": "LEIGH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-01",
        "last_updated": "2010-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "020137-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2010; 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.