Individual provider Active NPI

Lucinda Louise Wares, MS CCC-SLP

  • Speech-Language Pathologist
  • Boca Raton, FL
National Provider Identifier
1669449906
Registry record updated Oct 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA 10377 Issued in FL
Practice address
5501 N Military TRL Apt 106
Boca Raton, FL 33496-3481
Phone
(716) 997-2709
NPI assigned
Mar 7, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 012189 NY
Speech-Language Pathologist 235Z00000X 106348 TX
Speech-Language Pathologist 235Z00000X SA 10377 FL Primary

Addresses

Primary practice location

5501 N Military TRL Apt 106
Boca Raton, FL 33496-3481

Mailing address

5501 N Military TRL Apt 106
Boca Raton, FL 33496-3481
Phone (716) 997-2709

Other identifiers 1

IdentifierTypeStateIssuer
1669449906MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230609000329 FL Practitioner - Qualified Speech Language Pathologist 9335288372 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
106348TXMDProfessional Counselor
SA 10377FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Physical & Occupational Therapy Inc CurrentSince Jun 2, 2023 Accepting new patients
Chautauqua County Chapter of Nysarc Inc Past Accepting new patients

Locations

800 E Gate Blvd
Garden City, NY 11530

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1141689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381276800000",
    "number": "1669449906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5501 N MILITARY TRL APT 106",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334963481",
            "telephone_number": "716-997-2709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 N MILITARY TRL APT 106",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334963481",
            "telephone_number": "716-997-2709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARES",
        "first_name": "LUCINDA",
        "middle_name": "LOUISE",
        "credential": "MS CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-07",
        "last_updated": "2013-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "012189",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "106348",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA 10377",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1669449906",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2013; 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.