Individual provider Active NPI

Kristin Marie Basile, M.S. CCC-SLP

  • Speech-Language Pathologist
  • Staten Island, NY
National Provider Identifier
1629399936
Registry record updated Jul 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
019934 Issued in NY
Practice address
3767 Hylan Blvd
Staten Island, NY 10308-3535
Phone
(718) 285-5763
NPI assigned
Jun 21, 2010
Last updated
Jul 19, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2014

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 019934 NY Primary

Addresses

Primary practice location

3767 Hylan Blvd
Staten Island, NY 10308-3535

Mailing address

1445 73Rd St
FL2
Brooklyn, NY 11228-2111
Phone (718) 285-5763

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

NPI Registry JSON

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

{
    "created_epoch": "1277078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405728000000",
    "number": "1629399936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1445 73RD ST",
            "address_2": "FL2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112282111",
            "telephone_number": "718-285-5763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3767 HYLAN BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103083535",
            "telephone_number": "718-285-5763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASILE",
        "first_name": "KRISTIN",
        "middle_name": "MARIE",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-21",
        "last_updated": "2014-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "019934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2014; 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.