Individual provider Active NPI

Kristina Kalinova Lubliner, MS

  • Speech-Language Pathologist
  • Salem, OR
National Provider Identifier
1730776329
Registry record updated Dec 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
016851 Issued in OR
Practice address
1475 Capitol St NE
Salem, OR 97301-7850
Phone
(971) 599-1712
Fax
(888) 835-4257
NPI assigned
Dec 29, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 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 016851 OR Primary

Addresses

Primary practice location

1475 Capitol St NE
Salem, OR 97301-7850

Mailing address

1475 Capitol St NE
Salem, OR 97301-7850
Phone (971) 599-1712

Other names 1

  • Kristina Kalinova Stoeva Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211214002751 OR Practitioner - Qualified Speech Language Pathologist 3476943051 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16851ORMDMassage Therapist
016851ORMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Meridian Park Hospital CurrentSince Oct 22, 2021 Accepting new patients
Sensible Speech-Language Pathology, Inc Speech-Language Pathologist CurrentSince Jan 3, 2021 Accepting new patients
Legacy Meridian Park Hospital PastSince Oct 22, 2021 Accepting new patients

Locations

1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600

1475 Capitol St NE
Salem, OR 97301
Phone (971) 559-1712

19260 SW 65th Ave
Ste 165
Tualatin, OR 97062
Phone (503) 413-6534

19300 SW 65th Ave
Tualatin, OR 97062
Phone (503) 692-1212

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": "1609200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609200000000",
    "number": "1730776329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1475 CAPITOL ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973017850",
            "telephone_number": "971-599-1712",
            "fax_number": "888-835-4257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 CAPITOL ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973017850",
            "telephone_number": "971-599-1712",
            "fax_number": "888-835-4257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUBLINER",
        "first_name": "KRISTINA",
        "middle_name": "KALINOVA",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-29",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OR",
            "license": "016851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTINA",
            "last_name": "STOEVA",
            "middle_name": "KALINOVA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.