Individual provider Active NPI

Chelsea Marie Tisckos, AU.D.

  • Audiologist
  • Saint Louis, MO
National Provider Identifier
1033695143
Registry record updated Aug 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
Practice address
6400 Clayton Rd Ste 405
Saint Louis, MO 63117-1850
Phone
(314) 965-9184
NPI assigned
Jul 12, 2018
Last updated
Aug 17, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X Primary

Addresses

Primary practice location

6400 Clayton Rd Ste 405
Saint Louis, MO 63117-1850

Mailing address

15825 Manchester Rd Ste 209
Ellisville, MO 63011-2263

Other practice location 1

15825 Manchester Rd Ste 209
Ellisville, MO 63011-2263
Phone (636) 391-9622

Other practice location 2

1034 S Brentwood Blvd Ste 725
Saint Louis, MO 63117-1271
Phone (636) 391-9622

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190923000844 MO Practitioner - Qualified Audiologist 5890025647 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Or Monitoring Consultants IncGroup PAC ID 8123162153, 4 clinicians

Practice addresses (Care Compare)

12255 De Paul Dr
Suite 860
Bridgeton, MO 63044-2515
Phone (314) 394-1911

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Or Monitoring Consultants Inc Audiologist CurrentSince Dec 2, 2024 Accepting new patients
Ideal Practice Management Group Mi LLC Audiologist Past Accepting new patients
NHS South LLC PastSince Aug 23, 2020 Accepting new patients
Hearing Consultants Audiologist PastSince Dec 2, 2024 Accepting new patients
Audiology Consultants, LLC Audiologist PastSince Sep 25, 2019 Accepting new patients
Hearing Health Care, Inc. Audiologist PastSince Apr 11, 2005 Accepting new patients

Locations

12255 De Paul Dr
Ste 860
Bridgeton, MO 63044

1000 Lake Saint Louis Blvd
Ste 115
Lake St Louis, MO 63367

10097 Manchester Rd
Ste 102A
Saint Louis, MO 63122

Networks

  • IA HMO C-SNP
  • IA HMO

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1531353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597622400000",
    "number": "1033695143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15825 MANCHESTER RD STE 209",
            "city": "ELLISVILLE",
            "state": "MO",
            "postal_code": "630112263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 CLAYTON RD STE 405",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631171850",
            "telephone_number": "314-965-9184"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15825 Manchester Rd Ste 209",
            "address_purpose": "LOCATION",
            "city": "Ellisville",
            "state": "MO",
            "postal_code": "630112263",
            "country_code": "US",
            "telephone_number": "636-391-9622",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1034 S Brentwood Blvd Ste 725",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631171271",
            "country_code": "US",
            "telephone_number": "636-391-9622",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TISCKOS",
        "first_name": "CHELSEA",
        "middle_name": "MARIE",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-12",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.