Individual provider Active NPI

Kristina L Flevares

  • Speech-Language Pathologist
  • Rochester, NY
National Provider Identifier
1881858041
Registry record updated Feb 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
025411 Issued in NY
Practice address
3399 Winton Rd S
Rochester, NY 14623-3057
Phone
(585) 334-6000
Fax
(585) 334-2858
NPI assigned
Jul 16, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2020

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 025411 NY Primary

Addresses

Primary practice location

3399 Winton Rd S
Rochester, NY 14623-3057

Mailing address

3399 Winton Rd S
Rochester, NY 14623-3057
Phone (585) 334-6000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160521000099 NY Practitioner - Qualified Speech Language Pathologist 8921281353 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
025411NYMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
United Cerebral Palsy Association of the Rochester Area, Inc. CurrentSince Apr 11, 2016 Accepting new patients
Finger Lakes United Cerebral Palsy, Inc. PastSince Apr 11, 2016 Accepting new patients

Locations

50 Science Pkwy
Rochester, NY 14620
Phone 5853346000 ext. 1045

3399 Winton Rd S
Rochester, NY 14623

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": "1216166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580947200000",
    "number": "1881858041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3399 WINTON RD S",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146233057",
            "telephone_number": "585-334-6000",
            "fax_number": "585-334-2858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3399 WINTON RD S",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146233057",
            "telephone_number": "585-334-6000",
            "fax_number": "585-334-2858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLEVARES",
        "first_name": "KRISTINA",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-16",
        "last_updated": "2020-02-06",
        "certification_date": "2020-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "025411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 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.