Individual provider Active NPI

Jasmine Lewis

  • Speech-Language Pathologist
  • Staten Island, NY
National Provider Identifier
1750048153
Registry record updated Jan 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
033433 Issued in NY
Practice address
3391 Richmond Ave
Staten Island, NY 10312-2025
Phone
(718) 608-9170
NPI assigned
Nov 19, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2024

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 033433 NY Primary

Addresses

Primary practice location

3391 Richmond Ave
Staten Island, NY 10312-2025

Mailing address

729 Delafield Ave Apt 2
Staten Island, NY 10310-2329
Phone (718) 877-9618

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

State licenses

LicenseStateTypeSpecialty
033433NYMDSurgical Physician Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1637280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704585600000",
    "number": "1750048153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "729 DELAFIELD AVE APT 2",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103102329",
            "telephone_number": "718-877-9618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3391 RICHMOND AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103122025",
            "telephone_number": "718-608-9170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "JASMINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-19",
        "last_updated": "2024-01-07",
        "certification_date": "2024-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "033433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2024; 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.