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KAELI DIECKERT
NPI 1053834440
Speech-Language Pathologist in Queensbury, NY

Active since July 18, 2017
413 BAY RD, QUEENSBURY, NY 12804(518) 761-2025 Get Directions Write a Review

NPPES record last updated: January 6, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jan 6, 2020, Jul 18, 2017 (2 updates tracked since 2017).

About Kaeli Dieckert NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KAELI DIECKERT (NPI 1053834440) is an individual speech-language pathologist provider in Queensbury, New York, licensed in New York (026771-1) and active in the NPI registry since July 2017.

NPPES Registry Identity

NPI1053834440
Entity TypeIndividualFemale
Primary Taxonomy235Z00000X
Provider Legal NameKAELI DIECKERT
Location Address413 BAY RDQueensbury, NY 12804-1408
Mailing Address413 Bay RdQueensbury, NY 12804-1408
Phone(518) 761-2025
Sole ProprietorNo
Enumeration DateJuly 18, 2017
Last NPPES UpdateJanuary 6, 20202 updates tracked since enumeration
✔ NPI 1053834440 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpeech-Language PathologistSpeech, Language and Hearing Service Providers
Taxonomy Code235Z00000X
License✔ Licensed in NY · 026771-1
Definition
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.
413 BAY RD, Queensbury, NY 12804
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kaeli Dieckert is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignment

Medicare enrollment records show Kaeli Dieckert reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

State Of New York Comptrollers Office
10 mi
Developmental Disabilities
200 SMITH DR
Corinth, NY 12822
  • Reassigned Medicare billing, New York enrollment
  • 342 clinicians in this Medicare group
NPI 1003957424 (518) 654-7680

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARCELLA LYNN CARBONE
Specialist
413 BAY RD
QUEENSBURY, NY 12804
Warren County (518) 761-2025
ALLYSON M REYNOLDS
Speech-Language Pathologist
413 BAY RD
QUEENSBURY, NY 12804
Warren County (518) 761-2025
MACY ELLEN DUFRAIN
Specialist
413 BAY RD
QUEENSBURY, NY 12804
Warren County (518) 761-2025
MISS ERIN LYNN CALIGIURI LMSW
Social Worker
413 BAY RD
QUEENSBURY, NY 12804
Warren County (518) 761-2025
MRS. CHRIS ANN BOCKO-WETTERSTEN MASTERS IN EDUCATION
Specialist
413 BAY RD
QUEENSBURY, NY 12804
Warren County (518) 761-2025
SHAUNA M BROWN-KNOBEL NCBT, MSED
Specialist
413 BAY RD
QUEENSBURY, NY 12804
Warren County (518) 761-2025
JENNIFER ISLAS
Speech-Language Pathologist
413 BAY RD
QUEENSBURY, NY 12804
Warren County (518) 812-3586
ADIRONDACK ENRICHMENT
Early Intervention Provider Agency
413 BAY RD
QUEENSBURY, NY 12804
Warren County (518) 761-2025

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kaeli Dieckert's NPI number?

The NPI number for Kaeli Dieckert is 1053834440. It was assigned to this individual provider in the NPPES registry on July 18, 2017.

Where is Kaeli Dieckert located?

Kaeli Dieckert practices at 413 Bay Rd, Queensbury, NY 12804. The listed phone number is (518) 761-2025.

What is Kaeli Dieckert's specialty?

The primary specialty registered for this NPI is Speech-Language Pathologist with taxonomy code 235Z00000X.

Is Kaeli Dieckert enrolled in Medicare?

Yes. Kaeli Dieckert is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kaeli Dieckert's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kaeli Dieckert reassigns Medicare benefits to State Of New York Comptrollers Office (Corinth, NY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kaeli Dieckert's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Kaeli Dieckert was last updated on January 6, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.