Individual provider Active NPI

Rosemarie Elena Dacosta

  • Speech-Language Assistant
  • Riverdale, NY
National Provider Identifier
1639625478
Registry record updated Apr 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
1263102 Issued in NY
Practice address
555 Kappock Street
15M
Riverdale, NY 10463
Phone
(917) 723-2472
NPI assigned
Aug 31, 2016
Last updated
Apr 21, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 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 Assistant 2355S0801X 1263102 NY Primary

Addresses

Primary practice location

555 Kappock Street
15M
Riverdale, NY 10463

Mailing address

555 Kappock St
15M
Bronx, NY 10463-6420
Phone (917) 723-2472

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
1263102NYMDSpeech-Language Assistant

NPI Registry JSON

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

{
    "created_epoch": "1472601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492732800000",
    "number": "1639625478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 KAPPOCK ST",
            "address_2": "15M",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104636420",
            "telephone_number": "917-723-2472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 KAPPOCK STREET",
            "address_2": "15M",
            "city": "RIVERDALE",
            "state": "NY",
            "postal_code": "10463",
            "telephone_number": "917-723-2472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DACOSTA",
        "first_name": "ROSEMARIE",
        "middle_name": "ELENA",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-31",
        "last_updated": "2017-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "NY",
            "license": "1263102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverdale, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2017; 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.