Individual provider Active NPI

Tara Susan Bottone, M.A.,CCC-SLP,TSHH

  • Speech-Language Pathologist
  • Brooklyn, NY
National Provider Identifier
1952556987
Registry record updated Nov 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
017018 Issued in NY
Practice address
440 Atlantic Ave
Brooklyn, NY 11217-1704
Phone
(718) 260-8881
NPI assigned
Nov 18, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 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 017018 NY Primary

Addresses

Primary practice location

440 Atlantic Ave
Brooklyn, NY 11217-1704

Mailing address

829 Greenwood Ave
Apt 2 S
Brooklyn, NY 11218-1349
Phone (718) 909-5433

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
017018NYMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1226966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226966400000",
    "number": "1952556987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "829 GREENWOOD AVE",
            "address_2": "APT 2 S",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112181349",
            "telephone_number": "718-909-5433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 ATLANTIC AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112171704",
            "telephone_number": "718-260-8881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTTONE",
        "first_name": "TARA",
        "middle_name": "SUSAN",
        "name_prefix": "Ms.",
        "credential": "M.A.,CCC-SLP,TSHH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-18",
        "last_updated": "2008-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "017018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 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.