Individual provider Active NPI

Jessica Pelski, MS CCC-SLP

  • Speech-Language Pathologist
  • Kansas City, MO
National Provider Identifier
1841688827
Registry record updated Jan 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
3489 Issued in KS
Practice address
4454 Broadway
Kansas City, MO 64111-5907
Phone
(913) 645-4048
NPI assigned
Dec 29, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 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 3489 KS Primary

Addresses

Primary practice location

4454 Broadway
Kansas City, MO 64111-5907

Mailing address

4454 Broadway
Kansas City, MO 64111-5907
Phone (913) 645-4048

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220131000188 KS Practitioner - Qualified Speech Language Pathologist 4587057385 Reassigns benefits to 3 organizations
I20220228001974 MO Practitioner - Qualified Speech Language Pathologist 4587057385 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2700 Somerset Dr
Prairie Village, KS 66206-1173
Phone (913) 513-0220

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3489KSMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Key Rehabilitation, Inc CurrentSince Dec 2, 2024 Accepting new patients
Key Rehabilitation, Inc CurrentSince Dec 2, 2024 Accepting new patients

Locations

2020 N Tyler Rd
Wichita, KS 67212
Phone (316) 295-4591

1335 NW Broad St
Murfreesboro, TN 37129
Phone (615) 983-0240

Organizations & group practices 5

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": "1419811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643241600000",
    "number": "1841688827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4454 BROADWAY",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641115907",
            "telephone_number": "913-645-4048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4454 BROADWAY",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641115907",
            "telephone_number": "913-645-4048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELSKI",
        "first_name": "JESSICA",
        "credential": "MS CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-29",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "KS",
            "license": "3489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 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.