Individual provider Active NPI

Irina Vladimirovna Zaytseva, CCC-SLP

  • Speech-Language Pathologist
  • Hawthorne, NJ
National Provider Identifier
1962144022
Registry record updated Mar 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
41YS01134400
Practice address
55 Emeline Dr
Hawthorne, NJ 07506-3000
Phone
(201) 519-0293
NPI assigned
Apr 10, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X TL-3608 NJ
Speech-Language Pathologist 235Z00000X 41YS01134400 Primary

Addresses

Primary practice location

55 Emeline Dr
Hawthorne, NJ 07506-3000

Mailing address

55 Emeline Dr
Hawthorne, NJ 07506-3000

Other practice location 1

350 Oxford Rd
Oxford, NJ 07863-3224
Phone (908) 453-7700

Other practice location 2

145 State Park Rd
Blairstown, NJ 07825-4206
Phone (908) 459-4128

Other practice location 3

230 E Ridgewood Ave
Paramus, NJ 07652-4142
Phone (201) 967-4000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250620002446 NJ Practitioner - Qualified Speech Language Pathologist 7012429590 Practice locations: Hawthorne, NJ

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TL-3608NJMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1649548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741305600000",
    "number": "1962144022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 EMELINE DR",
            "city": "HAWTHORNE",
            "state": "NJ",
            "postal_code": "075063000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 EMELINE DR",
            "city": "HAWTHORNE",
            "state": "NJ",
            "postal_code": "075063000",
            "telephone_number": "201-519-0293"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 Oxford Rd",
            "address_purpose": "LOCATION",
            "city": "Oxford",
            "state": "NJ",
            "postal_code": "078633224",
            "country_code": "US",
            "telephone_number": "908-453-7700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "145 State Park Rd",
            "address_purpose": "LOCATION",
            "city": "Blairstown",
            "state": "NJ",
            "postal_code": "078254206",
            "country_code": "US",
            "telephone_number": "908-459-4128",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "230 E Ridgewood Ave",
            "address_purpose": "LOCATION",
            "city": "Paramus",
            "state": "NJ",
            "postal_code": "076524142",
            "country_code": "US",
            "telephone_number": "201-967-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZAYTSEVA",
        "first_name": "IRINA",
        "middle_name": "VLADIMIROVNA",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-10",
        "last_updated": "2025-03-07",
        "certification_date": "2025-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "TL-3608",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": "41YS01134400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hawthorne, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2025; 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.