Active NPI
Alexandra Morgan Bracy Menard, M.S., CCC-SLP
- Speech-Language Pathologist
- Webster, NY
National Provider Identifier
1700318169
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 026518
- Practice address
- 1015 Klem Rd
Alex Bracy- Room 113
Webster, NY 14580-8618 - Phone
- (585) 872-1770
- NPI assigned
- Apr 3, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 026518 | NY | Primary |
Addresses
Primary practice location
1015 Klem Rd
Alex Bracy- Room 113
Webster, NY 14580-8618
Mailing address
1015 Klem Rd
Alex Bracy- Room 113
Webster, NY 14580-8618
Phone (585) 872-1770
Other practice location 1
Bright Start Pediatric Services 149 N Main St
Fairport, NY 14450
Phone (585) 377-2230
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 488576 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bright Start Pediatric Services | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Early Intervention Provider Agency
- Fairport, NY
- NPI 1467618231
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1491177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597968000000",
"number": "1700318169",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1015 KLEM RD",
"address_2": "ALEX BRACY- ROOM 113",
"city": "WEBSTER",
"state": "NY",
"postal_code": "145808618",
"telephone_number": "585-872-1770"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1015 KLEM RD",
"address_2": "ALEX BRACY- ROOM 113",
"city": "WEBSTER",
"state": "NY",
"postal_code": "145808618",
"telephone_number": "585-872-1770"
}
],
"practiceLocations": [
{
"address_1": "Bright Start Pediatric Services 149 N Main St",
"address_purpose": "LOCATION",
"city": "Fairport",
"state": "NY",
"postal_code": "14450",
"country_code": "US",
"telephone_number": "585-377-2230",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MENARD",
"first_name": "ALEXANDRA",
"middle_name": "MORGAN BRACY",
"credential": "M.S., CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-04-03",
"last_updated": "2020-08-21",
"certification_date": "2020-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "026518",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "488576",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Webster, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.