Individual provider Active NPI

Tiana Rose Magnan, SLP

  • Speech-Language Pathologist
  • Raleigh, NC
National Provider Identifier
1679440572
Registry record updated Jun 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
30004442 Issued in NC
Practice address
4909 Waters Edge Dr
Raleigh, NC 27606-0039
Phone
(919) 285-1647
NPI assigned
Oct 23, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 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 30004442 NC Primary
Speech-Language Pathologist 235Z00000X 035807 NY

Addresses

Primary practice location

4909 Waters Edge Dr
Raleigh, NC 27606-0039

Mailing address

4909 Waters Edge Dr
Raleigh, NC 27606-0039
Phone (919) 285-1647

Other practice location 1

2550 Sweet Home Rd
Amherst, NY 14228-2225
Phone (716) 817-8855

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251031001789 NY Practitioner - Qualified Speech Language Pathologist 0648769398 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
State University of New York at Buffalo School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Buffalo Speech-Language Pathology, PCGroup PAC ID 9032534623, 10 clinicians

Practice addresses (Care Compare)

1404 Sweet Home Rd
Suite 9
Amherst, NY 14228-2778
Phone (716) 817-8855

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
035807NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Buffalo Speech-Language Pathology, PC Speech-Language Pathologist CurrentSince Oct 23, 2025 Accepting new patients

Locations

1404 Sweet Home Rd
Ste 9
Buffalo, NY 14228
Phone (716) 817-8855

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": "1761177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780876800000",
    "number": "1679440572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4909 WATERS EDGE DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276060039",
            "telephone_number": "919-285-1647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4909 WATERS EDGE DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276060039",
            "telephone_number": "919-285-1647"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2550 Sweet Home Rd",
            "address_purpose": "LOCATION",
            "city": "Amherst",
            "state": "NY",
            "postal_code": "142282225",
            "country_code": "US",
            "telephone_number": "716-817-8855",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAGNAN",
        "first_name": "TIANA",
        "middle_name": "ROSE",
        "name_prefix": "Ms.",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-23",
        "last_updated": "2026-06-08",
        "certification_date": "2026-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "30004442",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "035807",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2026; 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.