Individual provider Active NPI

Alea Ditillo Moody

  • Speech-Language Pathologist
  • Media, PA
National Provider Identifier
1649902289
Registry record updated Jun 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SL017292 Issued in PA
Practice address
77 W Baltimore Pike Ste 100B
Media, PA 19063-5639
Phone
(610) 850-0340
NPI assigned
Jun 30, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 41YS011444100 NJ
Speech-Language Pathologist 235Z00000X SL017292 PA Primary

Addresses

Primary practice location

77 W Baltimore Pike Ste 100B
Media, PA 19063-5639

Mailing address

77 W Baltimore Pike Ste 100B
Media, PA 19063-5639
Phone (610) 850-0340

Other practice location 1

1646 W Chester Pike Ste 4
West Chester, PA 19382-7979
Phone (610) 850-0340

Other practice location 2

1 Raymond Dr Unit B
Havertown, PA 19083-3100
Phone (610) 850-0340

Other names 1

  • Alea Gray Ditillo Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231114001163 NJ Practitioner - Qualified Speech Language Pathologist 4587011408 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
41YS011444100NJMDSpeech-Language Pathologist
SL017292PAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
MJ Kidz LLC Speech-Language Pathologist CurrentSince Nov 15, 2023 Accepting new patients

Locations

900 Haddon Ave
Ste 202
Collingswood, NJ 08108

751 Route 73 N
Ste 1
Marlton, NJ 08053
Phone (856) 823-1793

617 Auburn Ave
Ste 103
Swedesboro, NJ 08085
Phone (856) 467-6107

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1656547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780444800000",
    "number": "1649902289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 W BALTIMORE PIKE STE 100B",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190635639",
            "telephone_number": "610-850-0340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 W BALTIMORE PIKE STE 100B",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190635639",
            "telephone_number": "610-850-0340"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1646 W Chester Pike Ste 4",
            "address_purpose": "LOCATION",
            "city": "West Chester",
            "state": "PA",
            "postal_code": "193827979",
            "country_code": "US",
            "telephone_number": "610-850-0340",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Raymond Dr Unit B",
            "address_purpose": "LOCATION",
            "city": "Havertown",
            "state": "PA",
            "postal_code": "190833100",
            "country_code": "US",
            "telephone_number": "610-850-0340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOODY",
        "first_name": "ALEA",
        "middle_name": "DITILLO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-30",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS011444100",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL017292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEA",
            "last_name": "DITILLO",
            "middle_name": "GRAY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Media, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.