Individual provider Active NPI

Robert B Mytelka

  • Speech/Language/Hearing Specialist/Technologist
  • Chestnut Ridge, NY
National Provider Identifier
1902453467
Registry record updated Aug 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech/Language/Hearing Specialist/TechnologistTaxonomy code 235500000X
Practice address
750 Chestnut Ridge Rd Unit 223
Chestnut Ridge, NY 10977-6443
Phone
(845) 517-5060
NPI assigned
Aug 20, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech/Language/Hearing Specialist/Technologist 235500000X Primary

Addresses

Primary practice location

750 Chestnut Ridge Rd Unit 223
Chestnut Ridge, NY 10977-6443

Mailing address

750 Chestnut Ridge Rd Unit 223
Chestnut Ridge, NY 10977-6443
Phone (845) 558-7573

Other practice location 1

9555 W Sam Houston Pkwy S Ste 155
Houston, TX 77099-2145
Phone (845) 558-7573

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Care & Alert Systems LLC CurrentSince Jul 24, 2022 Accepting new patients
Care & Alert Systems LLC CurrentSince Sep 1, 2019 Accepting new patients

Locations

750 Chestnut Ridge Rd
Unit 223
Spring Valley, NY 10977
Phone (845) 517-5060

9555 W Sam Houston Pkwy S
Ste 155
Houston, TX 77099
Phone (845) 558-7573

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": "1566259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566259200000",
    "number": "1902453467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 CHESTNUT RIDGE RD UNIT 223",
            "city": "CHESTNUT RIDGE",
            "state": "NY",
            "postal_code": "109776443",
            "telephone_number": "845-558-7573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 CHESTNUT RIDGE RD UNIT 223",
            "city": "CHESTNUT RIDGE",
            "state": "NY",
            "postal_code": "109776443",
            "telephone_number": "845-517-5060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9555 W Sam Houston Pkwy S Ste 155",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770992145",
            "country_code": "US",
            "telephone_number": "845-558-7573",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MYTELKA",
        "first_name": "ROBERT",
        "middle_name": "B",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-20",
        "last_updated": "2019-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235500000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chestnut Ridge, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.