Individual provider Active NPI

Steven Dinerman

  • Speech-Language Pathologist
  • Prescott, AZ
National Provider Identifier
1861532046
Registry record updated Dec 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP4657 Issued in AZ
Practice address
519 E Virginia PL
Prescott, AZ 86301-3129
Phone
(928) 713-0018
NPI assigned
Feb 7, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2012

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 SLP4657 AZ Primary

Addresses

Primary practice location

519 E Virginia PL
Prescott, AZ 86301-3129

Mailing address

1150 N Cottonwood Spring Dr
Dewey, AZ 86327-5407

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090624000190 AZ Practitioner - Qualified Speech Language Pathologist 5890846331 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SLP4657AZMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Prescott Speech & Language Services Inc. Speech-Language Pathologist CurrentSince Jul 1, 2009 Accepting new patients
High Country Early Intervention Inc Speech-Language Pathologist PastSince Sep 9, 2019 Accepting new patients

Locations

812 Valley St
Prescott, AZ 86305
Phone (928) 445-1309

Organizations & group practices 2

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": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355788800000",
    "number": "1861532046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 N COTTONWOOD SPRING DR",
            "city": "DEWEY",
            "state": "AZ",
            "postal_code": "863275407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 E VIRGINIA PL",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863013129",
            "telephone_number": "928-713-0018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DINERMAN",
        "first_name": "STEVEN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2012-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "SLP4657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.