Mary Therese Polvino

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

032725 Issued in NY

Practice address

774 Fairmount Ave
Jamestown, NY 14701-2609

Phone

(716) 338-0668

NPI assigned

Nov 29, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Hope Speech Pathology PLLC

  • Speech-Language Pathologist
  • Orchard Park, NY
  • NPI 1366927147
  Medicare reassignment NPD

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

{
    "created_epoch": "1638144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1992463764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "774 FAIRMOUNT AVE",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147012609",
            "telephone_number": "716-338-0668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "774 FAIRMOUNT AVE",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147012609",
            "telephone_number": "716-338-0668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLVINO",
        "first_name": "MARY",
        "middle_name": "THERESE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-29",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "032725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emilyann Pleszewski
• Podiatry Associates of Jamestown
• Surjeet Pohar, MD
• Eugenie M Poignard, PT DPT
• Richard Ryan Kenneth Pollino
• Donald Pool, LMSW
• Tamsin J. Pope, D.C.
• Daniel James Potter
• Catherine Elaine Powers, MD
• Elizabeth Eileen Powers, PT

• Speech-Language Pathologist in Jamestown, NY
• Providers in Jamestown, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2023; 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.