Jessica Anne Randall, MA, CCC-SLP, TSSLD

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

029004 Issued in NY

Practice address

507 Deer Park Rd
Dix Hills, NY 11746-5207

Phone

(631) 549-4900

NPI assigned

Jun 28, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Jessica Anne Diaz-Perez Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

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.

• Marion K. Salomon

  • Early Intervention Provider Agency
  • Plainview, NY
  • NPI 1770846677
  NPD (past)

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

{
    "created_epoch": "1530144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749254400000",
    "number": "1679068829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 BROADWAY",
            "city": "MASSAPEQUA PARK",
            "state": "NY",
            "postal_code": "117621844",
            "telephone_number": "516-974-6905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 DEER PARK RD",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117465207",
            "telephone_number": "631-549-4900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "307 Eagle Ave",
            "address_purpose": "LOCATION",
            "city": "West Hempstead",
            "state": "NY",
            "postal_code": "115523819",
            "country_code": "US",
            "telephone_number": "516-986-9580",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "125 E Bethpage Rd",
            "address_purpose": "LOCATION",
            "city": "Plainview",
            "state": "NY",
            "postal_code": "118034228",
            "country_code": "US",
            "telephone_number": "516-731-5588",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "189 Wheatley Rd",
            "address_purpose": "LOCATION",
            "city": "Glen Head",
            "state": "NY",
            "postal_code": "115452641",
            "country_code": "US",
            "telephone_number": "516-626-1075",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RANDALL",
        "first_name": "JESSICA",
        "middle_name": "ANNE",
        "credential": "MA, CCC-SLP, TSSLD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-28",
        "last_updated": "2025-06-07",
        "certification_date": "2025-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "029004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05979424",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "DIAZ-PEREZ",
            "middle_name": "ANNE",
            "credential": "MA, CCC-SLP, TSSLD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jennifer-Ann Margaret Ramanand, MA
• Zuleima Ramirez
• Ravi Ramjit, PHD
• Sandy Ramos, M.A.
• Brittany Ramppen
• Alexandra Rattien, LCSW
• Elena Reicher, PTA
• Jessica Anne Reis
• Milton J Reitman, M.D.
• Amanda I Rekas

• Speech-Language Pathologist in Dix Hills, NY
• Providers in Dix Hills, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2025; 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.