Individual provider Active NPI

Amy Zwislewski, MA, FAAA

  • Audiologist
  • Philadelphia, PA
National Provider Identifier
1053560417
Registry record updated Sep 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AT000949L Issued in PA
Practice address
8350 Roosevelt Blvd
Philadelphia, PA 19152-2531
Phone
(215) 331-6878
Fax
(215) 331-4152
NPI assigned
Sep 10, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AT000949L PA Primary

Addresses

Primary practice location

8350 Roosevelt Blvd
Philadelphia, PA 19152-2531

Mailing address

151 Canterbury LN
Lansdale, PA 19446-6303
Phone (215) 362-1817

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081027000040 PA Practitioner - Qualified Audiologist 9739247396 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Otolaryngology Associates PCGroup PAC ID 0941299895, 9 clinicians

Practice addresses (Care Compare)

205 N Broad St
Suite 401
Philadelphia, PA 19107-1553
Phone (215) 762-4600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
AT000949LPAMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
University Otolaryngology Associates PC CurrentSince Oct 1, 2008 Accepting new patients
Fornance Physician Services, Inc. CurrentSince Nov 1, 2021 Accepting new patients
Fornance Physician Services, Inc Current Accepting new patients
Fornance Physician Services, Inc. CurrentSince Nov 1, 2021 Accepting new patients

Locations

210 Mall Blvd
Ste 102
Kng of Prussa, PA 19406
Phone (610) 265-0726

8350 Roosevelt Blvd
Philadelphia, PA 19152
Phone (215) 331-6878

205 N Broad St
Ste 401
Philadelphia, PA 19107
Phone (215) 569-3155

Organizations & group practices 4

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": "1221004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221004800000",
    "number": "1053560417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 CANTERBURY LN",
            "city": "LANSDALE",
            "state": "PA",
            "postal_code": "194466303",
            "telephone_number": "215-362-1817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8350 ROOSEVELT BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191522531",
            "telephone_number": "215-331-6878",
            "fax_number": "215-331-4152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZWISLEWSKI",
        "first_name": "AMY",
        "credential": "MA, FAAA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-10",
        "last_updated": "2008-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "PA",
            "license": "AT000949L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2008; 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.