Individual provider Active NPI

Kristina A Fahy, MS, CCC-SLP

  • Speech-Language Pathologist
  • Rochester, NY
National Provider Identifier
1821348285
Registry record updated Sep 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
013826-1 Issued in NY
Practice address
131 W. Broad St.
Rochester, NY 14614
Phone
(585) 262-8100
Fax
(585) 334-2858
NPI assigned
Sep 13, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2023

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 013826-1 NY Primary

Addresses

Primary practice location

131 W. Broad St.
Rochester, NY 14614

Mailing address

131 W. Broad St.
Rochester, NY 14614
Phone (585) 262-8100

Other practice location 1

695 Bay Road
Hillside Family of Agencies-Halpern Education Center
Webster, NY 14580
Phone (585) 787-8042

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)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
013826NYMDSpeech-Language Pathologist
013826-1NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1347494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1821348285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 W. BROAD ST.",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14614",
            "telephone_number": "585-262-8100",
            "fax_number": "585-334-2858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 W. BROAD ST.",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14614",
            "telephone_number": "585-262-8100",
            "fax_number": "585-334-2858"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "695 Bay Road",
            "address_2": "Hillside Family of Agencies-Halpern Education Center",
            "address_purpose": "LOCATION",
            "city": "Webster",
            "state": "NY",
            "postal_code": "14580",
            "country_code": "US",
            "telephone_number": "585-787-8042",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAHY",
        "first_name": "KRISTINA",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-13",
        "last_updated": "2023-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "013826-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; 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.