MRS. NIKISHA NICOLE CLEMENTIN (M.ED. CCC-SLP) – Speech-Language Pathologist, NPI 1861662157
Speech-Language Pathologist
Main info
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Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for MRS. NIKISHA NICOLE CLEMENTIN (M.ED. CCC-SLP)
435, Sedgewood Circle, Stratford Pointe, West Melbourne, Brevard County, Florida, 32904, United States
WEST MELBOURNE, FL 329048041
Phone: (832) 315-7454
Type: Location
545 KYLAR DR NW
PALM BAY, FL 329076806
Phone: (832) 315-7454
Type: Location
2080 W EAU GALLIE BLVD STE A
MELBOURNE, FL 329353185
Phone: (407) 694-3603
Fax: (321) 296-7130
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-06-24
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20240613004293 | I | Qualified Speech Language Pathologist | TX | TBD |
| I20240624000555 | I | Qualified Speech Language Pathologist | FL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 32904)
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