Individual provider Active NPI

Elyse Tirella

  • Hearing Instrument Specialist
  • Winter Garden, FL
National Provider Identifier
1033809850
Registry record updated May 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Instrument SpecialistTaxonomy code 237700000X
License
AST1219 Issued in FL
Practice address
13750 W Colonial Dr Ste 330
Winter Garden, FL 34787-6142
Phone
(407) 745-4595
NPI assigned
May 15, 2023
Last updated
May 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Instrument Specialist 237700000X AST1219 FL Primary

Addresses

Primary practice location

13750 W Colonial Dr Ste 330
Winter Garden, FL 34787-6142

Mailing address

13750 W Colonial Dr Ste 330
Winter Garden, FL 34787-6142
Phone (407) 745-4595

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AST1219FLMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Lifestyle Hearing Corporation USA Inc Hearing Instrument Specialist CurrentSince May 21, 2023 Accepting new patients
Audiology Distribution, LLC PastSince May 21, 2023 Accepting new patients

Locations

13750 W Colonial Dr
Ste 330
Winter Garden, FL 34787
Phone (407) 745-4595

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 2

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": "1684108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684108800000",
    "number": "1033809850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13750 W COLONIAL DR STE 330",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347876142",
            "telephone_number": "407-745-4595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13750 W COLONIAL DR STE 330",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347876142",
            "telephone_number": "407-745-4595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIRELLA",
        "first_name": "ELYSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-15",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "FL",
            "license": "AST1219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Garden, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.