Individual provider Active NPI

Michelle Theresa Iocco, CCC-SLP

  • Speech-Language Pathologist
  • Brooklyn, NY
National Provider Identifier
1780160291
Registry record updated Feb 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
029527 Issued in NY
Practice address
4211 14TH Ave
Brooklyn, NY 11219-1404
Phone
(718) 633-1186
NPI assigned
Jul 17, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 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 029527 NY Primary

Addresses

Primary practice location

4211 14TH Ave
Brooklyn, NY 11219-1404

Mailing address

4211 14TH Ave
Brooklyn, NY 11219-1404
Phone (718) 633-1186

Other practice location 1

134 W 26th St Rm 602
New York, NY 10001-6803
Phone (212) 604-9360

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
029527NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
City Sounds of Ny Past Accepting new patients

Organizations & group practices 1

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": "1531785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580774400000",
    "number": "1780160291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4211 14TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112191404",
            "telephone_number": "718-633-1186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4211 14TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112191404",
            "telephone_number": "718-633-1186"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "134 W 26th St Rm 602",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100016803",
            "country_code": "US",
            "telephone_number": "212-604-9360",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IOCCO",
        "first_name": "MICHELLE",
        "middle_name": "THERESA",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-17",
        "last_updated": "2020-02-04",
        "certification_date": "2020-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "029527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 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.