Individual provider Active NPI

Jenna Marie Capozzi, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Bayside, NY
National Provider Identifier
1659883874
Registry record updated Mar 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
028290-1 Issued in NY
Practice address
2901 216TH St
Bayside, NY 11360-2810
Phone
(718) 281-8800
NPI assigned
Oct 27, 2017
Last updated
Mar 12, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2019

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 028290-1 NY Primary

Addresses

Primary practice location

2901 216TH St
Bayside, NY 11360-2810

Mailing address

1 Expressway PLZ
Roslyn Heights, NY 11577-2047
Phone (516) 621-2681

Other practice location 1

1 Expressway Plz
Roslyn Heights, NY 11577-2047
Phone (516) 621-2681

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231229001275 NY Practitioner - Qualified Speech Language Pathologist 8224488465 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
028290NYMDOccupational Therapist
028290-1NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Jan 29, 2024 Accepting new patients
New York University CurrentSince Jan 29, 2024 Accepting new patients

Locations

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 2

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": "1509062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552348800000",
    "number": "1659883874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EXPRESSWAY PLZ",
            "city": "ROSLYN HEIGHTS",
            "state": "NY",
            "postal_code": "115772047",
            "telephone_number": "516-621-2681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 216TH ST",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113602810",
            "telephone_number": "718-281-8800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Expressway Plz",
            "address_purpose": "LOCATION",
            "city": "Roslyn Heights",
            "state": "NY",
            "postal_code": "115772047",
            "country_code": "US",
            "telephone_number": "516-621-2681",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAPOZZI",
        "first_name": "JENNA",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-27",
        "last_updated": "2019-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "028290-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2019; 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.