Individual provider Active NPI

Miri Schmookler, CCC, SLP

  • Speech-Language Pathologist
  • Lakewood, NJ
National Provider Identifier
1790395705
Registry record updated Aug 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
41YS01015100 Issued in NJ
Practice address
13 Flannery Ave
Lakewood, NJ 08701-4751
Phone
(718) 419-0604
NPI assigned
Aug 4, 2020
Last updated
Aug 5, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 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 41YS01015100 NJ Primary

Addresses

Primary practice location

13 Flannery Ave
Lakewood, NJ 08701-4751

Mailing address

13 Flannery Ave
Lakewood, NJ 08701-4751
Phone (718) 419-0604

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200811001859 NJ Practitioner - Qualified Speech Language Pathologist 1456777242 Reassigns benefits to 2 organizations
Practice locations: Toms River, NJ

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
41YS01015100NJMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
At Home by Enhance Therapies LLC Speech-Language Pathologist CurrentSince Dec 10, 2021 Accepting new patients
Core PT LLC CurrentSince Aug 5, 2020 Accepting new patients
Link Home Services of NJ LLC Speech-Language Pathologist CurrentSince Sep 1, 2020 Accepting new patients
PT on the Go PC PastSince Aug 8, 2021 Accepting new patients

Locations

180 Sylvan Ave
Ste 401
Englewood Cliffs, NJ 07632
Phone (347) 841-8943

516 Sylvan Ave
Englewood Cliffs, NJ 07632

411 Hackensack Ave
Ste 200
Hackensack, NJ 07601
Phone (732) 987-3833

400 Route 70
Lakewood, NJ 08701
Phone (440) 263-9228

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1596499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596585600000",
    "number": "1790395705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 FLANNERY AVE",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087014751",
            "telephone_number": "718-419-0604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 FLANNERY AVE",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087014751",
            "telephone_number": "718-419-0604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMOOKLER",
        "first_name": "MIRI",
        "credential": "CCC, SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-04",
        "last_updated": "2020-08-05",
        "certification_date": "2020-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS01015100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 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.