Stacy Ilyse Huttman, MS, CCC -SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA6532 Issued in FL

Practice address

19312 Skyridge Cir
Boca Raton, FL 33498-6212

Phone

(561) 852-7752

NPI assigned

Feb 3, 2010

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Stacy Ilyse Dershaw Former name

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

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.

• Speech Rehab Services LLC

  • Home Health Agency
  • Boca Raton, FL
  • NPI 1114268927
  NPD (past)

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

{
    "created_epoch": "1265155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316649600000",
    "number": "1851623748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19312 SKYRIDGE CIR",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334986212",
            "telephone_number": "561-852-7752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19312 SKYRIDGE CIR",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334986212",
            "telephone_number": "561-852-7752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUTTMAN",
        "first_name": "STACY",
        "middle_name": "ILYSE",
        "credential": "MS, CCC -SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-03",
        "last_updated": "2011-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA6532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACY",
            "last_name": "DERSHAW",
            "middle_name": "ILYSE",
            "credential": "MS, CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Saira Hussain, MD
• Janneth Hutcher
• Joy Anne Hutcherson, MED, CCC-SLP
• Meghan Elizabeth Hutt, PA
• Jeffrey Paul Huttman, PH.D.
• Aurelie Huyghues-Despointes
• Karen Hwang, DPT
• Paul M Hyman, MD
• Gilbert Ruben Hyppolite Jr.
• Lauresha Hysa, M.D.

• Speech-Language Pathologist in Boca Raton, FL
• Providers in Boca Raton, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2011; 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.