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Kimberly Ivelisses Dejesus , MS CCC-SLP

Speech-Language Pathologist β€’ Palm Coast, FL

Active NPI 1225433659 Individual Practitioner Female Practitioner
Practice location in NPPES

393 Palm Coast Pkwy Sw
Palm Coast, FL 32137

Call 3864469935 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

393 Palm Coast Pkwy Sw

Palm Coast, FL 32137

Telephone 3864469935
Organization at the Same NPPES Address or Phone
Speech Works Pediatric Therapy, Llc Facility NPI 1245488121

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2014

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Palm Coast and Florida

63 active clinicians are listed under Speech-Language Pathologist with a practice address in Palm Coast, FL (11,513 in Florida).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Palm Coast

0% of these 63 clinicians have the CMS telehealth indicator.

1.6% of these 63 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Speech-Language Pathologist Primary Specialty

NUCC Taxonomy Code: 235Z00000X

License # reported to NPPES FL 16249

The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Florida Department of Health Medical Quality Assurance.
Look Up on State Board Site

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

1 listed
John Papczynski , OTR, L

Occupational Therapist

NPI 1770344632

Occupational Therapist Registered, L

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

15 Historical Events
πŸ“
Updated Practice Location June 04, 2018

Registered at 393 PALM COAST PKWY SW, PALM COAST, FL 32137 (Tel: 3864469935)

πŸ‘€
Provider Name / Credentials Updated June 04, 2018

Recorded as KIMBERLY DEJESUS, M.S. CCC-SLP

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) June 04, 2018

Speech-Language Pathologist (license number reported to NPPES: FL 16249)

πŸ‘€
Provider Name / Credentials Updated April 11, 2018

Recorded as KIMBERLY DEJESUS

βœ…
NPI Profile Active June 19, 2017

NPI status registered as active in NPPES database

πŸ“
Updated Practice Location June 19, 2017

Registered at 393 PALM COAST PKWY SW, PALM COAST, FL 321374773 (Tel: 3864469935)

πŸ“
Updated Business Mailing Address June 19, 2017

Registered at 97 ROYAL OAK DR, PALM COAST, FL 321646925 (Tel: 3868640027)

πŸ‘€
Provider Name / Credentials Updated June 19, 2017

Recorded as KIMBERLY RIVERA

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) June 19, 2017

Specialist/Technologist (license number reported to NPPES: FL SI2191)

βœ…
NPI Profile Active October 28, 2014

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) October 28, 2014

Registered at 393 PALM COAST PKWY SW, PALM COAST, FL 321374773 (Tel: 3864469935)

πŸ“
Business Mailing Address (Initial Record) October 28, 2014

Registered at 97 ROYAL OAK DR, PALM COAST, FL 321646925 (Tel: 3868640027)

πŸ‘€
Provider Name / Credentials (Initial Record) October 28, 2014

Recorded as KIMBERLY RIVERA

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) October 28, 2014

Specialist/Technologist (license number reported to NPPES: FL SI2191)

🟒
Initial NPI Registration & Enumeration October 28, 2014

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1225433659
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 28, 2014
Last Update: June 04, 2018
Sole Proprietor: No

Mailing Address

97 Royal Oak Dr

Palm Coast, FL 321646925

Phone: 3868640027

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.