Organization Active NPI

Preferred Audiology Care, LLC

  • Hearing and Speech Clinic/Center
  • Camillus, NY
National Provider Identifier
1033449558
Registry record updated Jan 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing and Speech Clinic/CenterTaxonomy code 261QH0700X
License
002209 Issued in NY
Legal business name
PREFERRED AUDIOLOGY CARE, LLC
Practice address
5639 W Genesee St
Camillus, NY 13031-1250
Phone
(315) 468-2985
Fax
(315) 468-6892
NPI assigned
Jan 5, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2010

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

Authorized official

Name
Dr. Nicole Marie Anzalone, AU.D.NPI 1265684310
Title
Audiologist/President
Phone
(315) 692-4692

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
Hearing and Speech Clinic/Center 261QH0700X 002209 NY Primary

Addresses

Primary practice location

5639 W Genesee St
Camillus, NY 13031-1250

Mailing address

5639 W Genesee St
Camillus, NY 13031-1250
Phone (315) 468-2985

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100308000265 NY Part B Supplier - Clinic/Group Practice 3870638463 Receives reassigned benefits from 4 practitioners
Practice locations: Camillus, NY

National Provider Directory

National Provider Directory

Locations

307 Kasson Rd
Camillus, NY 13031

Practitioners & affiliated clinicians

Practitioners 6

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": "1262649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262649600000",
    "number": "1033449558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5639 W GENESEE ST",
            "city": "CAMILLUS",
            "state": "NY",
            "postal_code": "130311250",
            "telephone_number": "315-468-2985",
            "fax_number": "315-468-6892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5639 W GENESEE ST",
            "city": "CAMILLUS",
            "state": "NY",
            "postal_code": "130311250",
            "telephone_number": "315-468-2985",
            "fax_number": "315-468-6892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREFERRED AUDIOLOGY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-05",
        "last_updated": "2010-01-05",
        "status": "A",
        "authorized_official_last_name": "ANZALONE",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "AUDIOLOGIST/PRESIDENT",
        "authorized_official_telephone_number": "315-692-4692",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "AU.D."
    },
    "taxonomies": [
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": "NY",
            "license": "002209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camillus, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2010; 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.