Organization Active NPI

Hearing and Tinnitus Management Audiology PLLC

  • Audiologist-Hearing Aid Fitter
  • Stony Brook, NY
National Provider Identifier
1013340017
Registry record updated Aug 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Audiologist-Hearing Aid FitterTaxonomy code 237600000X
License
001972-1 Issued in NY
Legal business name
HEARING AND TINNITUS MANAGEMENT AUDIOLOGY PLLC
Practice address
207 Hallock Rd
Suite 208
Stony Brook, NY 11790-3033
Phone
(631) 780-4327
Fax
(631) 675-6867
NPI assigned
Aug 13, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2013

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

Authorized official

Name
Dr. Elena Luise Maresca-Robertson, AU.D.NPI 1801004858
Title
Owner
Phone
(631) 780-4327

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid FitterGroup: 193400000X SINGLE SPECIALTY GROUP 237600000X 001972-1 NY Primary

Addresses

Primary practice location

207 Hallock Rd
Suite 208
Stony Brook, NY 11790-3033

Mailing address

207 Hallock Rd
Suite 208
Stony Brook, NY 11790-3033
Phone (631) 780-4327

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130830000225 NY Part B Supplier - Clinic/Group Practice 5991948523 Receives reassigned benefits from 1 practitioner
Practice locations: Stony Brook, NY

National Provider Directory

National Provider Directory

Locations

2500 Nesconset Hwy
Bldg 3
Stony Brook, NY 11790
Phone (631) 751-7772

2500 Nesconset Hwy
Ste A
Stony Brook, NY 11790
Phone (631) 780-4327

207 Hallock Rd
Ste 208
Stony Brook, NY 11790
Phone (631) 780-4327

2500 Nesconset Hwy
Bldg 3A
Stony Brook, NY 11790
Phone (631) 780-4327

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1376352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376352000000",
    "number": "1013340017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 HALLOCK RD",
            "address_2": "SUITE 208",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117903033",
            "telephone_number": "631-780-4327",
            "fax_number": "631-675-6867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 HALLOCK RD",
            "address_2": "SUITE 208",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117903033",
            "telephone_number": "631-780-4327",
            "fax_number": "631-675-6867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARING AND TINNITUS MANAGEMENT AUDIOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-13",
        "last_updated": "2013-08-13",
        "status": "A",
        "authorized_official_last_name": "MARESCA-ROBERTSON",
        "authorized_official_first_name": "ELENA",
        "authorized_official_middle_name": "LUISE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-780-4327",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "AU.D."
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "NY",
            "license": "001972-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2013; 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.