Individual provider Active NPI

Cari Lauren Mutnick

  • Speech-Language Pathologist
  • Flushing, NY
National Provider Identifier
1912184581
Registry record updated Jan 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
017759 Issued in NY
Practice address
14461 Roosevelt Ave
Flushing, NY 11354-6252
Phone
(718) 939-8700
NPI assigned
Jan 25, 2008
Last updated
Jan 25, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2008

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 017759 NY Primary

Addresses

Primary practice location

14461 Roosevelt Ave
Flushing, NY 11354-6252

Mailing address

320 E 23Rd St
Apartment 6F
New York, NY 10010-4713

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

State licenses

LicenseStateTypeSpecialty
017759NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
The Shield of David, Inc. PastSince Jan 11, 1996 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1201219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201219200000",
    "number": "1912184581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 E 23RD ST",
            "address_2": "APARTMENT 6F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100104713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14461 ROOSEVELT AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113546252",
            "telephone_number": "718-939-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTNICK",
        "first_name": "CARI",
        "middle_name": "LAUREN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-25",
        "last_updated": "2008-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "017759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2008; 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.