Individual provider Active NPI

Svetlana Atenzon

  • Speech-Language Pathologist
  • White Plains, NY
National Provider Identifier
1891079943
Registry record updated Nov 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
021086 Issued in NY
Practice address
470 Mamaroneck Ave Ste 204
White Plains, NY 10605-1839
Phone
(914) 421-8272
NPI assigned
Oct 7, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 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 021086 NY Primary

Addresses

Primary practice location

470 Mamaroneck Ave Ste 204
White Plains, NY 10605-1839

Mailing address

Telemedicine Services
1040 West Fingerboard Rd
Staten Island, NY 10304

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240515002350 NY Practitioner - Qualified Speech Language Pathologist 9133514821 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Homeside Rehab PT OT SLP LLCGroup PAC ID 7810045309, 45 clinicians

Practice addresses (Care Compare)

441 Route 306
Suite 2
Monsey, NY 10952-1234
Phone (718) 377-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
108810TXMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Homeside Rehab, PT, OT, SLP LLC Speech-Language Pathologist CurrentSince Apr 6, 2024 Accepting new patients

Locations

441 Route 306
Ste 2
Monsey, NY 10952
Phone (201) 952-4436

296 Route 59
Ste 1225
Suffern, NY 10901

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": "1317945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605830400000",
    "number": "1891079943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "TELEMEDICINE SERVICES",
            "address_2": "1040 WEST FINGERBOARD RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 MAMARONECK AVE STE 204",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106051839",
            "telephone_number": "914-421-8272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATENZON",
        "first_name": "SVETLANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-07",
        "last_updated": "2020-11-20",
        "certification_date": "2020-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "021086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Plains, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2020; 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.