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EDJAE VILLAMOR SIRIBAN MA, CCC-SLP
NPI 1316678782
Speech-Language Pathologist in New York, NY

Active since June 17, 2022
1901 1ST AVE, NEW YORK, NY 10029(212) 423-6262 Get Directions Write a Review

NPPES record last updated: April 11, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Edjae Villamor Siriban Ma, Ccc-slp NPPES

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

EDJAE VILLAMOR SIRIBAN MA, CCC-SLP (NPI 1316678782) is an individual speech-language pathologist provider in New York, New York and active in the NPI registry since June 2022. She maintains a secondary practice location in Fort Lee.

NPPES Registry Identity

NPI1316678782
Entity TypeIndividualFemale
Primary Taxonomy235Z00000X
Provider Legal NameEDJAE VILLAMOR SIRIBANCredential: MA, CCC-SLP
Location Address1901 1ST AVENew York, NY 10029-7494
Mailing Address1315 Anderson Ave Apt 23Fort Lee, NJ 07024-1732
Phone(212) 423-6262
Sole ProprietorNo
Enumeration DateJune 17, 2022
Last NPPES UpdateApril 11, 2025
NPPES CertifiedApril 11, 2025
✔ NPI 1316678782 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
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.
1901 1ST AVE, New York, NY 10029
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Secondary Practice Location 1

Location 1100 Central Ave Apt 5BFort Lee, NJ 07024-7311 · Phone (973) 534-8796

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Edjae Villamor Siriban Ma, Ccc-slp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignment

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

Physician Affiliate Group Of New York PC
2.1 mi
Dietitian, Registered
506 LENOX AVE
New York, NY 10037
  • Reassigned Medicare billing, New York enrollment
  • 2,094 clinicians in this Medicare group
NPI 1013375526 (212) 939-2467

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.

KENNETH BOMPAROLA PA
Physician Assistant
1901 1ST AVE
NEW YORK, NY 10029
New York County (212) 423-6262
ESEOGHENE INYANG AKAMUNE PHARMD
Pharmacist (Pharmacotherapy)
1901 1ST AVE
NEW YORK, NY 10029
New York County (212) 423-6262
JONATHAN CHABON MD
Emergency Medicine
1901 1ST AVE
NEW YORK, NY 10029
New York County (212) 423-6684
KRITI BHANDARI MD
Student in an Organized Health Care Education/Training Program
1901 1ST AVE
NEW YORK, NY 10029
New York County (646) 988-5168
SEBASTIAN MARK MENDEZ
Psychiatry & Neurology (Psychiatry)
1901 1ST AVE
NEW YORK, NY 10029
New York County (646) 672-3143
KYRA QUYNN MANAYAN-LEONARD MD
Student in an Organized Health Care Education/Training Program
1901 1ST AVE
NEW YORK, NY 10029
New York County (844) 692-4692
ELENA ALAYETO LCSW
Social Worker (Clinical)
1901 1ST AVE
NEW YORK, NY 10029
New York County (212) 423-8633
BEATA EDYTA POPIS-MATEJAK MD
Internal Medicine (Critical Care Medicine)
1901 1ST AVE
NEW YORK, NY 10029
New York County (212) 423-6771

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 Edjae Siriban's NPI number?

The NPI number for Edjae Siriban is 1316678782. It was assigned to this individual provider in the NPPES registry on June 17, 2022.

Where is Edjae Siriban located?

Edjae Siriban practices at 1901 1st Ave, New York, NY 10029. The listed phone number is (212) 423-6262.

What is Edjae Siriban's specialty?

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

Is Edjae Siriban enrolled in Medicare?

Yes. Edjae Siriban is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Edjae Siriban's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Edjae Siriban reassigns Medicare benefits to Physician Affiliate Group Of New York PC (New York, 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 Edjae Siriban'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 Edjae Siriban was last updated on April 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months 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.