Mary Roosa, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

006248 Issued in NY

Practice address

345 Mountain View Avenue
Port Ewen, NY 12466-0549

Phone

(845) 338-1945

NPI assigned

Nov 9, 2011

Last updated

Oct 12, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Kingston City Schools

  • Local Education Agency (LEA)
  • Kingston, NY
  • NPI 1265585780
  NPD (past)

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

{
    "created_epoch": "1320796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350000000000",
    "number": "1811274566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 CROWN ST",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124013833",
            "telephone_number": "845-338-1945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 MOUNTAIN VIEW AVENUE",
            "city": "PORT EWEN",
            "state": "NY",
            "postal_code": "124660549",
            "telephone_number": "845-338-1945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROOSA",
        "first_name": "MARY",
        "name_prefix": "Mrs.",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-09",
        "last_updated": "2012-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "006248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Port Ewen Pharmacy Inc
• Port Ewen RX Inc (Port Ewen Pharmacy)
• Racquel Praino, MS, RD
• Barbara Ann Price, RPH
• Gregory Rogers, SPEECH AND LANGUAGE
• Peter James Rubertone
• Cheyanne Tallas Sandy
• Dana Mary Schechter, RPH
• Lori D Schwark, OTR
• Kate Elizabeth Shellhammer

• Speech-Language Pathologist in Port Ewen, NY
• Providers in Port Ewen, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2012; 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.