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CARISSA GREVENGOED M.S., CCC-SLP
NPI 1073104055
Speech-Language Pathologist in Peabody, MA

Active since February 01, 2021
96 FOREST ST, PEABODY, MA 01960(772) 480-7068 Get Directions Write a Review

NPPES record last updated: September 6, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 6, 2022, Dec 27, 2021, Feb 1, 2021 (3 updates tracked since 2021).

About Carissa Grevengoed M.s., Ccc-slp NPPES

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

CARISSA GREVENGOED M.S., CCC-SLP (NPI 1073104055) is an individual speech-language pathologist provider in Peabody, Massachusetts, licensed in Massachusetts (78648-SP-SL) and active in the NPI registry since February 2021. She maintains a secondary practice location in Vero Beach and is a graduate of Other (2020).

NPPES Registry Identity

NPI1073104055
Entity TypeIndividualFemale
Primary Taxonomy235Z00000X
Provider Legal NameCARISSA GREVENGOEDCredential: M.S., CCC-SLP
Location Address96 FOREST STPeabody, MA 01960-3907
Mailing Address3730 7th Ter Ste 202Vero Beach, FL 32960-7325
Phone(772) 480-7068
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateFebruary 1, 2021
Last NPPES UpdateSeptember 6, 20223 updates tracked since enumeration
NPPES CertifiedSeptember 6, 2022
✔ NPI 1073104055 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
Licenses✔ Licensed in MA · 78648-SP-SL✔ Licensed in FL · 9936
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.
96 FOREST ST, Peabody, MA 01960
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Secondary Practice Location 1

Location 13730 7th Ter Ste 202Vero Beach, FL 32960-7325 · Phone (772) 480-7068

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Carissa Grevengoed M.s., Ccc-slp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9234698747
PECOS Enrollment IDI20260825005033

Medicare Billing Reassignment

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

Legacy Healthcare Services, Inc
1,181 mi
Physical Therapist
17470 BROOKSIDE TRACE CT
Tampa, FL 33647
  • Reassigned Medicare billing, Florida enrollment
  • 264 clinicians in this Medicare group
NPI 1336535988 (813) 443-5042

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.

MS. MARY CATHERINE NOONAN OTR
Occupational Therapist
96 FOREST ST
PEABODY, MA 01960
Essex County (978) 532-0303
OLIVIA CARDI
Occupational Therapy Assistant
96 FOREST ST
PEABODY, MA 01960
Essex County (978) 532-0303
CHRISTINA PALMER PTA
Physical Therapy Assistant
96 FOREST ST
PEABODY, MA 01960
Essex County (978) 532-0300
HANNAH ROSE ALBEE OTR/L
Occupational Therapist
96 FOREST ST
PEABODY, MA 01960
Essex County (978) 532-0303
MS. LINA POUM COTA
Occupational Therapy Assistant
96 FOREST ST
PEABODY, MA 01960
Essex County (508) 333-1340
KERRI-ANNE V KELLEY PTA
Physical Therapy Assistant
96 FOREST ST
PEABODY, MA 01960
Essex County (978) 532-0303
JOANN LAURA DAIGLE COTA
Occupational Therapy Assistant
96 FOREST ST
PEABODY, MA 01960
Essex County (978) 532-0303
DENISE BOCCHINO COTA/L
Occupational Therapy Assistant
96 FOREST ST
PEABODY, MA 01960
Essex County (978) 532-0303

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 Carissa Grevengoed's NPI number?

The NPI number for Carissa Grevengoed is 1073104055. It was assigned to this individual provider in the NPPES registry on February 1, 2021.

Where is Carissa Grevengoed located?

Carissa Grevengoed practices at 96 Forest St, Peabody, MA 01960. The listed phone number is (772) 480-7068.

What is Carissa Grevengoed's specialty?

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

Is Carissa Grevengoed enrolled in Medicare?

Yes. Carissa Grevengoed is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Carissa Grevengoed's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Carissa Grevengoed reassigns Medicare benefits to Legacy Healthcare Services, Inc (Tampa, FL). 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 Carissa Grevengoed'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 Carissa Grevengoed was last updated on September 6, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.