AMANDA RAE STANEK, MS CCC-SLP — NPI 1962695080 (Licensed & Credentialed Specialist/Technologist in ROBERTS, WI)

CMS-1500 Box 24J / 33a • NPI

1962695080

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

235500000X

Licensed & Credentialed Specialist/Technologist

Box 32 Service Location & ZIP+4

204 W WARREN ST, ROBERTS, WI, 54023-9617

✓ 9-Digit EDI 837 ZIP+4 (54023-9617)

Practice Phone & Referral Fax

(715) 749-3890

Fax: (715) 749-4081

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1962695080 (AMANDA RAE STANEK, MS CCC-SLP) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1962695080` (NPI-1 Individual Practitioner)
Provider / Legal Name	AMANDA RAE STANEK, MS CCC-SLP
Plain-English Specialty	Licensed & Credentialed Specialist/Technologist NUCC Code: `235500000X` (Specialist/Technologist)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	204 W WARREN ST, ROBERTS, WI, 54023-9617
Practice Telephone / Fax	Tel: (715) 749-3890 \| Fax: (715) 749-4081
Administrative Mailing Address	204 W WARREN ST, ROBERTS, WI, 54023-9617
Enumeration & Last Sync	Enumerated: 2007-08-22 \| CMS Record Updated: 2010-06-29

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

204 W WARREN ST, ROBERTS, WI, 54023-9617

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Plain-English Taxonomy & CMS Crosswalk (235500000X)

What Does Taxonomy Code 235500000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 235500000X translates to:
"Licensed & Credentialed Specialist/Technologist"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Specialist/Technologist for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (AMANDA RAE STANEK, MS CCC-SLP)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`235Z00000X` — Speech-Language Pathologist, Plain English: Licensed & Credentialed Speech, Language and Hearing Service Providers	State: WI \| License: `683620` \| Primary: Secondary
`235Z00000X` — Speech-Language Pathologist, Plain English: Licensed & Credentialed Speech, Language and Hearing Service Providers	State: WI \| License: `3037-154` \| Primary: Secondary
`235500000X` — Specialist/Technologist Plain English: Licensed & Credentialed Specialist/Technologist	State: WI \| License: `3037-154` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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AMANDA RAE STANEK, MS CCC-SLP (NPI #1962695080)