Individual provider Active NPI

Andrew Manardo, MS, CCC-SLP

  • Speech-Language Pathologist
  • Grosse Pointe Woods, MI
National Provider Identifier
1669198412
Registry record updated Jun 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7101008674 Issued in MI
Practice address
1940 Manchester Blvd
Grosse Pointe Woods, MI 48236-1922
Phone
(313) 489-0308
NPI assigned
Oct 13, 2022
Last updated
Jun 16, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2025

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 7101008674 MI Primary

Addresses

Primary practice location

1940 Manchester Blvd
Grosse Pointe Woods, MI 48236-1922

Mailing address

1940 Manchester Blvd
Grosse Pointe Woods, MI 48236-1922
Phone (313) 489-0308

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221207002950 MI Practitioner - Qualified Speech Language Pathologist 9234508599 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
New York University School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Behavioral Outcomes Management,LLCGroup PAC ID 1355602426, 18 clinicians

Practice addresses (Care Compare)

210 Town Ctr Dr
Troy, MI 48084-1774
Phone (248) 643-8900

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7101008674MIMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Andrew Manardo SLP PLLC Speech-Language Pathologist CurrentSince Nov 9, 2025 Accepting new patients
Behavioral Outcomes Management,LLC Speech-Language Pathologist CurrentSince Nov 1, 2022 Accepting new patients

Locations

210 Town Center Dr
Troy, MI 48084
Phone (248) 643-8900

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": "1665619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750032000000",
    "number": "1669198412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1940 MANCHESTER BLVD",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482361922",
            "telephone_number": "313-489-0308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 MANCHESTER BLVD",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482361922",
            "telephone_number": "313-489-0308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANARDO",
        "first_name": "ANDREW",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-10-13",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101008674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grosse Pointe Woods, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2025; 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.