Individual provider Active NPI

Deborah Elizabeth Witthauer, M.S., CF-SLP

  • Speech-Language Pathologist
  • Bellerose, NY
National Provider Identifier
1710599709
Registry record updated Aug 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
24419 86TH Rd
Bellerose, NY 11426-1623
Phone
(718) 490-3044
NPI assigned
Aug 20, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2020

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 Primary

Addresses

Primary practice location

24419 86TH Rd
Bellerose, NY 11426-1623

Mailing address

24419 86TH Rd
Bellerose, NY 11426-1623
Phone (718) 490-3044

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, AZ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230221001335 NY Practitioner - Qualified Speech Language Pathologist 4587036546 Reassigns benefits to 1 organization
I20260609000242 AZ Practitioner - Qualified Speech Language Pathologist 4587036546 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1 W Elliot Rd
Suite 109
Tempe, AZ 85284-1310

9820 N Central Ave
Unit 226
Phoenix, AZ 85020-1060

9820 N Central Ave Unit
Suite 226
Phoenix, AZ 85020-1060

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Shield of David, Inc. CurrentSince Feb 8, 2023 Accepting new patients
Ally Pediatric Therapy LLC Speech-Language Pathologist Past Accepting new patients

Locations

3909 214th Pl
Flushing, NY 11361
Phone (718) 229-5757

14461 Roosevelt Ave
Flushing, NY 11354
Phone (718) 886-1534

Organizations & group practices 3

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": "1597881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597881600000",
    "number": "1710599709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24419 86TH RD",
            "city": "BELLEROSE",
            "state": "NY",
            "postal_code": "114261623",
            "telephone_number": "718-490-3044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24419 86TH RD",
            "city": "BELLEROSE",
            "state": "NY",
            "postal_code": "114261623",
            "telephone_number": "718-490-3044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITTHAUER",
        "first_name": "DEBORAH",
        "middle_name": "ELIZABETH",
        "credential": "M.S., CF-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-20",
        "last_updated": "2020-08-20",
        "certification_date": "2020-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellerose, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2020; 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.