Individual provider Active NPI

Kristi Nicole Waletitsch

  • Speech-Language Pathologist
  • Blue Point, NY
National Provider Identifier
1851181945
Registry record updated May 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
036724 Issued in NY
Practice address
235 Blue Point Ave
Blue Point, NY 11715-1261
Phone
(631) 358-0790
NPI assigned
May 12, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2026

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 036724 NY Primary

Addresses

Primary practice location

235 Blue Point Ave
Blue Point, NY 11715-1261

Mailing address

235 Blue Point Ave
Blue Point, NY 11715-1261

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

State licenses

LicenseStateTypeSpecialty
036724NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1747008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780185600000",
    "number": "1851181945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 BLUE POINT AVE",
            "city": "BLUE POINT",
            "state": "NY",
            "postal_code": "117151261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 BLUE POINT AVE",
            "city": "BLUE POINT",
            "state": "NY",
            "postal_code": "117151261",
            "telephone_number": "631-358-0790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALETITSCH",
        "first_name": "KRISTI",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-12",
        "last_updated": "2026-05-31",
        "certification_date": "2026-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "036724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blue Point, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2026; 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.