Individual provider Active NPI

Ainsley S Martin, CCC-SLP

  • Speech-Language Pathologist
  • Syracuse, NY
National Provider Identifier
1720624828
Registry record updated Nov 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
026425 Issued in NY
Practice address
365 E Seneca Tpke
Syracuse, NY 13205-2455
Phone
(315) 372-6110
NPI assigned
Nov 23, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X 026425 NY Primary

Addresses

Primary practice location

365 E Seneca Tpke
Syracuse, NY 13205-2455

Mailing address

365 E Seneca Tpke
Syracuse, NY 13205-2455
Phone (315) 372-6110

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200813003236 NY Practitioner - Qualified Speech Language Pathologist 6002232568 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

365 E Seneca Tpke
Syracuse, NY 13205-2455
Phone (315) 372-6110

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
026425NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ainsley S. Martin, Speech-Language Pathology, PLLC Single Specialty CurrentSince May 24, 2020 Accepting new patients
Community Memorial Hospital Single Specialty Past Accepting new patients

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": "1574467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574467200000",
    "number": "1720624828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 E SENECA TPKE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132052455",
            "telephone_number": "315-372-6110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 E SENECA TPKE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132052455",
            "telephone_number": "315-372-6110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "AINSLEY",
        "middle_name": "S",
        "name_prefix": "Ms.",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-23",
        "last_updated": "2019-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "026425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2019; 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.