Individual provider Active NPI

Thresa Korczak, M.S. CF-SLP

  • Speech-Language Pathologist
  • Cedar Rapids, IA
National Provider Identifier
1831930775
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
125741 Issued in IA
Practice address
202 35TH Street Dr SE
Cedar Rapids, IA 52403-1353
Phone
(319) 458-5521
NPI assigned
Jun 4, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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 125741 IA Primary

Addresses

Primary practice location

202 35TH Street Dr SE
Cedar Rapids, IA 52403-1353

Mailing address

4501 Fairlane Dr NE
Cedar Rapids, IA 52402-2306
Phone (815) 756-0452

Other practice location 1

5710 Gibson Dr NE
Cedar Rapids, IA 52411-6671
Phone (319) 826-1094

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240716002060 IA Practitioner - Qualified Speech Language Pathologist 2264977164 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Medical CenterGroup PAC ID 4183535271, 295 clinicians

Practice addresses (Care Compare)

5264 Council St NE
Suite 300
Cedar Rapids, IA 52402-2472
Phone (319) 398-6020

701 10TH St SE
Cedar Rapids, IA 52403-1251

701 10TH St SE
Cedar Rapids, IA 52403-1292

701 10TH St SE J Edward Lundy
Mercy Pediatric Clinic
Cedar Rapids, IA 52403-1251
Phone (319) 832-2328

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125741IAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Medical Center Current Accepting new patients
Mercy Medical Center CurrentSince May 1, 2025 Accepting new patients
Mercy Medical Center CurrentSince May 1, 2025 Accepting new patients

Locations

5264 Council St NE
Cedar Rapids, IA 52402
Phone (319) 221-8444

701 10th St SE
Cedar Rapids, IA 52403
Phone (319) 398-6011

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": "1717459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1831930775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4501 FAIRLANE DR NE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524022306",
            "telephone_number": "815-756-0452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 35TH STREET DR SE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524031353",
            "telephone_number": "319-458-5521"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5710 Gibson Dr NE",
            "address_purpose": "LOCATION",
            "city": "Cedar Rapids",
            "state": "IA",
            "postal_code": "524116671",
            "country_code": "US",
            "telephone_number": "319-826-1094",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KORCZAK",
        "first_name": "THRESA",
        "credential": "M.S. CF-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-04",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IA",
            "license": "125741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; 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.