Individual provider Active NPI

Rebecca K Connors, MS CCC-SLP

  • Speech-Language Pathologist
  • New York, NY
National Provider Identifier
1821714080
Registry record updated Oct 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
032429-01 Issued in NY
Practice address
1110 2ND Ave RM 302
New York, NY 10022-2021
Phone
(212) 842-0080
NPI assigned
Oct 18, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2022

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 032429-01 NY Primary

Addresses

Primary practice location

1110 2ND Ave RM 302
New York, NY 10022-2021

Mailing address

1110 2ND Ave RM 302
New York, NY 10022-2021
Phone (212) 842-0080

Other identifiers 1

IdentifierTypeStateIssuer
032429-01OtherNYSLP LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL N/A

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221111000526 NY Practitioner - Qualified Speech Language Pathologist 3072980663 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrative Speech Therapy PLLCGroup PAC ID 9335426535, 2 clinicians

Practice addresses (Care Compare)

79 Wave St
Staten Island, NY 10304-2728
Phone (248) 231-3744

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
032429-01NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Outreach Physical and Occupational Therapy & Speech Rehabilitation, PLLC Speech-Language Pathologist CurrentSince Oct 11, 2022 Accepting new patients
Integrative Speech Therapy PLLC Speech-Language Pathologist CurrentSince Jun 16, 2025 Accepting new patients
Juniper Speech and Swallowing Nyc, PLLC Speech-Language Pathologist Current Accepting new patients

Locations

3 Grace Ave
Ste 119
Great Neck, NY 11021
Phone (212) 842-0080

1110 2nd Ave
Rm 302
New York, NY 10022
Phone (212) 842-0080

Organizations & group practices 3

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": "1666051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666051200000",
    "number": "1821714080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 2ND AVE RM 302",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100222021",
            "telephone_number": "212-842-0080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 2ND AVE RM 302",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100222021",
            "telephone_number": "212-842-0080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNORS",
        "first_name": "REBECCA",
        "middle_name": "K",
        "credential": "MS CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-18",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "032429-01",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SLP LICENSE",
            "identifier": "032429-01",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "N/A",
            "affiliation": "N",
            "address_1": "1110 2nd Ave Rm 302",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100222021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.