Individual provider Active NPI

Tatevik Ananyan

  • Speech-Language Pathologist
  • Laurel, MD
National Provider Identifier
1992471296
Registry record updated Feb 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
14409 Greenview Dr Ste 102
Laurel, MD 20708-4213
Phone
(301) 498-8100
Fax
(301) 498-0009
NPI assigned
Aug 18, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2023

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 02436L MD
Speech-Language Pathologist 235Z00000X Primary

Addresses

Primary practice location

14409 Greenview Dr Ste 102
Laurel, MD 20708-4213

Mailing address

22 Glenbrook Rd
Hicksville, NY 11801-4834
Phone (917) 900-8474

Other identifiers 2

IdentifierTypeStateIssuer
02436LOtherMDMARYLAND DEPARTMENT OF HEALTH
032706OtherNYNEW YORK STATE EDUCATION DEPARTMENT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230929002162 NY Practitioner - Qualified Speech Language Pathologist 8628422268 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ats Rehab OT and PT and SLP PLLCGroup PAC ID 2567734452, 39 clinicians

Practice addresses (Care Compare)

6180 Woodhaven Blvd
Rego Park, NY 11374-2742
Phone (732) 399-9700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
02436LMDMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ats Rehab OT & PT & SLP PLLC Speech-Language Pathologist CurrentSince Jan 24, 2025 Accepting new patients
Ny Speech Pathology Consultants, P.C. Speech-Language Pathologist CurrentSince Aug 6, 2023 Accepting new patients
Associated Professional Rehabilitation Services, Inc. Speech-Language Pathologist PastSince Dec 5, 2021 Accepting new patients
Rehabilitation Services, Inc. Speech-Language Pathologist PastSince Dec 5, 2021 Accepting new patients

Locations

1105 E County Line Rd
Ste 213
Lakewood, NJ 08701

10825 Horace Harding Expy
Flushing, NY 11368
Phone (516) 216-4108

274 W Broadway
Long Beach, NY 11561
Phone (516) 431-1400

6180 Woodhaven Blvd
Rego Park, NY 11374
Phone (718) 446-4300

Organizations & group practices 4

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": "1629244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1992471296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 GLENBROOK RD",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118014834",
            "telephone_number": "917-900-8474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14409 GREENVIEW DR STE 102",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207084213",
            "telephone_number": "301-498-8100",
            "fax_number": "301-498-0009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANANYAN",
        "first_name": "TATEVIK",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-18",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "02436L",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARYLAND DEPARTMENT OF HEALTH",
            "identifier": "02436L",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW YORK STATE EDUCATION DEPARTMENT",
            "identifier": "032706",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.