Individual provider Active NPI

Lisa Kimberly Grovenstein, AUD

  • Audiologist
  • Jacksonville, FL
National Provider Identifier
1073124400
Registry record updated Aug 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AY2395 Issued in FL
Practice address
3 Shircliff Way Ste 322
Jacksonville, FL 32204-4780
Phone
(904) 384-8088
Fax
(904) 384-4745
NPI assigned
Aug 10, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
AudiologistGroup: 193400000X SINGLE SPECIALTY GROUP 231H00000X AY2395 FL Primary

Addresses

Primary practice location

3 Shircliff Way Ste 322
Jacksonville, FL 32204-4780

Mailing address

11945 San Jose Blvd Ste 300
Jacksonville, FL 32223-1627
Phone (904) 396-1725

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200904001729 FL Practitioner - Qualified Audiologist 6305263369 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Florida Surgeons PAGroup PAC ID 2769381391, 336 clinicians

Practice addresses (Care Compare)

4203 Belfort Rd
Suite 340
Jacksonville, FL 32216-1409
Phone (904) 880-0911

Merit-based Incentive Payment System (MIPS)

Final score
81.79 of 100Reported as group
Quality
64.42
Promoting interoperability
100
Improvement activities
40
Cost
74.88

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
North Florida Surgeons, PA CurrentSince Aug 11, 2020 Accepting new patients
North Florida Surgeons, PA Single Specialty CurrentSince Aug 11, 2020 Accepting new patients

Locations

11945 San Jose Blvd
Ste 300
Jacksonville, FL 32223

2 Shircliff Way
Ste 920
Jacksonville, FL 32204
Phone (904) 308-1380

3 Shircliff Way
Ste 322
Jacksonville, FL 32204
Phone (904) 384-8088

4203 Belfort Rd
Ste 340
Jacksonville, FL 32216
Phone (904) 880-0911

11945 San Jose Blvd
Ste 102
Jacksonville, FL 32223
Phone (904) 268-3937

11705 San Jose Blvd
Ste 103
Jacksonville, FL 32223
Phone (904) 880-0911

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1597017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597017600000",
    "number": "1073124400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11945 SAN JOSE BLVD STE 300",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322231627",
            "telephone_number": "904-396-1725",
            "fax_number": "904-396-4893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 SHIRCLIFF WAY STE 322",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044780",
            "telephone_number": "904-384-8088",
            "fax_number": "904-384-4745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROVENSTEIN",
        "first_name": "LISA",
        "middle_name": "KIMBERLY",
        "credential": "AUD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-10",
        "last_updated": "2020-08-10",
        "certification_date": "2020-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Audiologist",
            "state": "FL",
            "license": "AY2395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

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