Individual provider Active NPI

Kristine Lucente

  • Speech-Language Pathologist
  • Palm Bay, FL
National Provider Identifier
1881965119
Registry record updated Jan 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA 4004 Issued in FL
Practice address
987 Piedmont Ave NE
Palm Bay, FL 32907-1428
Phone
(321) 266-0282
NPI assigned
Jan 18, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 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 SA 4004 FL Primary

Addresses

Primary practice location

987 Piedmont Ave NE
Palm Bay, FL 32907-1428

Mailing address

987 Piedmont Ave NE
Palm Bay, FL 32907-1428

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230809001440 FL Practitioner - Qualified Speech Language Pathologist 8820450729 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SA 4004FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
QRM Plus Florida SLP LLC Speech-Language Pathologist CurrentSince Jun 1, 2023 Accepting new patients

Locations

670 Flushing Ave
Ste 307
Brooklyn, NY 11206

5057 Keller Springs Rd
Ste 150
Addison, TX 75001
Phone (800) 420-1036

Organizations & group practices 1

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": "1326844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326844800000",
    "number": "1881965119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "987 PIEDMONT AVE NE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329071428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "987 PIEDMONT AVE NE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329071428",
            "telephone_number": "321-266-0282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCENTE",
        "first_name": "KRISTINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-18",
        "last_updated": "2012-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA 4004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Bay, FL

Sources for this page

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