Active NPI
Kristin Burgos, MS CCC-SLP
- Speech-Language Pathologist
- Brighton, MA
National Provider Identifier
1831585447
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 024629
- Practice address
- 154 Nonantum St
Apt 1
Brighton, MA 02135-2410 - Phone
- (631) 835-8949
- NPI assigned
- Apr 9, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 024629 | NY | Primary |
| Speech-Language Pathologist | 235Z00000X | SP-9506-SL | MA |
Addresses
Primary practice location
154 Nonantum St
Apt 1
Brighton, MA 02135-2410
Mailing address
154 Nonantum St
Apt 1
Brighton, MA 02135-2410
Phone (631) 835-8949
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 024629 | NY | MD | Physical Therapist |
| SP-9506-SL | MA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1428537600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1428537600000",
"number": "1831585447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "154 NONANTUM ST",
"address_2": "APT 1",
"city": "BRIGHTON",
"state": "MA",
"postal_code": "021352410",
"telephone_number": "631-835-8949"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "154 NONANTUM ST",
"address_2": "APT 1",
"city": "BRIGHTON",
"state": "MA",
"postal_code": "021352410",
"telephone_number": "631-835-8949"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURGOS",
"first_name": "KRISTIN",
"credential": "MS CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-04-09",
"last_updated": "2015-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "024629",
"primary": true
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MA",
"license": "SP-9506-SL",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brighton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.