Individual provider Active NPI

Sarah A Mistretta, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Concord, MA
National Provider Identifier
1740771807
Registry record updated Mar 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
77042 Issued in MA
Practice address
133 Old Road to 9 Acre Cor
Concord, MA 01742-4159
Phone
(978) 369-1400
NPI assigned
May 24, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X 113669 TX
Speech-Language Pathologist 235Z00000X 77042 MA Primary

Addresses

Primary practice location

133 Old Road to 9 Acre Cor
Concord, MA 01742-4159

Mailing address

133 Old Road to 9 Acre Cor
Concord, MA 01742-4159

Other practice location 1

109 S Festival Dr
El Paso, TX 79912-5801
Phone (915) 842-1788

Other practice location 2

2 Coolidge St
Hudson, MA 01749-1321
Phone (978) 568-8800

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

State licenses

LicenseStateTypeSpecialty
77042MAMDSpeech-Language Pathologist
113669TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Childrens Therapies PastSince Oct 13, 2019 Accepting new patients
Integrated Children'S Therapies, Inc. Speech-Language Pathologist PastSince Oct 13, 2019 Accepting new patients
RGTG, LLC Single Specialty Past Accepting new patients

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": "1527120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585440000000",
    "number": "1740771807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 OLD ROAD TO 9 ACRE COR",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017424159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 OLD ROAD TO 9 ACRE COR",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017424159",
            "telephone_number": "978-369-1400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "109 S Festival Dr",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799125801",
            "country_code": "US",
            "telephone_number": "915-842-1788",
            "fax_number": "915-842-1778",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 Coolidge St",
            "address_purpose": "LOCATION",
            "city": "Hudson",
            "state": "MA",
            "postal_code": "017491321",
            "country_code": "US",
            "telephone_number": "978-568-8800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MISTRETTA",
        "first_name": "SARAH",
        "middle_name": "A",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-24",
        "last_updated": "2020-03-29",
        "certification_date": "2020-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "113669",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MA",
            "license": "77042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 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.

Verify at the official NPI Registry.