Individual provider Active NPI

Roraine Kleist, AUD

  • Audiologist
  • Prince Frederick, MD
National Provider Identifier
1003373283
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
01468 Issued in MD
Practice address
131 Main St Ste 202
Prince Frederick, MD 20678-3341
Phone
(410) 535-6975
Fax
(410) 535-6915
NPI assigned
Feb 25, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 01468 MD Primary

Addresses

Primary practice location

131 Main St Ste 202
Prince Frederick, MD 20678-3341

Mailing address

4000 Mitchellville Rd Ste A414
Bowie, MD 20716-3142
Phone (301) 860-0985

Other practice location 1

4000 Mitchellville Rd Ste A414
Bowie, MD 20716-3142
Phone (301) 860-0985

Other identifiers 1

IdentifierTypeStateIssuer
1139160260OtherMDOTOLARYNGOLOGY

Other names 1

  • Roraine Bunag Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190509001440 DC Practitioner - Qualified Audiologist 8921341116
I20190509001626 MD Practitioner - Qualified Audiologist 8921341116 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Annapolis ENT Surgical Center LLC CurrentSince Jul 1, 2024 Accepting new patients
Rocket Balance, LLC Past Accepting new patients
Annapolis ENT Surgical Center, LLC Past Accepting new patients

Locations

2002 Medical Pkwy
Ste 230
Annapolis, MD 21401
Phone (410) 226-3900

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1551052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1003373283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 MITCHELLVILLE RD STE A414",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207163142",
            "telephone_number": "301-860-0985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 MAIN ST STE 202",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206783341",
            "telephone_number": "410-535-6975",
            "fax_number": "410-535-6915"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4000 Mitchellville Rd Ste A414",
            "address_purpose": "LOCATION",
            "city": "Bowie",
            "state": "MD",
            "postal_code": "207163142",
            "country_code": "US",
            "telephone_number": "301-860-0985",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KLEIST",
        "first_name": "RORAINE",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-25",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MD",
            "license": "01468",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTOLARYNGOLOGY",
            "identifier": "1139160260",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RORAINE",
            "last_name": "BUNAG",
            "credential": "AUD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Prince Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.