Allison Mary Ickstadt

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

1174 Fortune CT
Wantagh, NY 11793-2759

Phone

(516) 221-1431

NPI assigned

Jul 28, 2020

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

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Priority One Therapy PT OT SLP PLLC

  dba @Home Therapy

  • Rehabilitation Practitioner
  • Oceanside, NY
  • NPI 1447517453
  Medicare reassignment NPD
• Kids in Action

  • Early Intervention Provider Agency
  • Islip, NY
  • NPI 1790143311
  NPD (past)
• Kids in Action of L.I. Inc.

  • Specialist
  • Islip, NY
  • NPI 1366596579
  NPD (past)

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

{
    "created_epoch": "1595894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595894400000",
    "number": "1871102608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1174 FORTUNE CT",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "117932759",
            "telephone_number": "516-221-1431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1174 FORTUNE CT",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "117932759",
            "telephone_number": "516-221-1431"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "252 Islip Ave",
            "address_purpose": "LOCATION",
            "city": "Islip",
            "state": "NY",
            "postal_code": "117513015",
            "country_code": "US",
            "telephone_number": "631-581-6800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ICKSTADT",
        "first_name": "ALLISON",
        "middle_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-28",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacy M Humphreys, NPP
• Leon Huynh
• Frank Sung Hwang, MD
• Nicole Iannarone, MA, BCBA
• Gabrielle L Ibraham
• Edward F Immel, OTR
• Imperium Physical Therapy PLLC
• Christine Impieri
• Lynne Intintoli
• Deepa Madhavan Ipektchi, D.D.S.

• Speech-Language Pathologist in Wantagh, NY
• Providers in Wantagh, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2020; 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.