Individual provider Active NPI

Amanda Zelaya, CCC-LSLP

  • Speech-Language Pathologist
  • Troy, NY
National Provider Identifier
1962862243
Registry record updated Mar 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
023706 Issued in NY
Practice address
79 102ND St
Troy, NY 12180-1125
Phone
(518) 273-6600
Fax
(518) 273-9567
NPI assigned
Mar 1, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2016

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 023706 NY Primary

Addresses

Primary practice location

79 102ND St
Troy, NY 12180-1125

Mailing address

132 Woodin Rd
Halfmoon, NY 12065-6135

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190603001095 NY Practitioner - Qualified Speech Language Pathologist 1052644242 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Disability Services Past Accepting new patients
Center for Disability Services, Inc Past Accepting new patients

Organizations & group practices 3

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": "1456790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456790400000",
    "number": "1962862243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 WOODIN RD",
            "city": "HALFMOON",
            "state": "NY",
            "postal_code": "120656135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 102ND ST",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121801125",
            "telephone_number": "518-273-6600",
            "fax_number": "518-273-9567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZELAYA",
        "first_name": "AMANDA",
        "name_prefix": "Mrs.",
        "credential": "CCC-LSLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-01",
        "last_updated": "2016-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "023706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2016; 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.