Active NPI
Courtney Ann Roth
- Audiologist
- Hicksville, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- Practice address
- 73A E Old Country Rd
Hicksville, NY 11801-4200 - Phone
- (516) 520-8736
- Fax
- (516) 433-4840
- NPI assigned
- May 8, 2019
- Last updated
- May 8, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | NU | Primary |
Addresses
Primary practice location
73A E Old Country Rd
Hicksville, NY 11801-4200
Mailing address
8 Elderwood LN
Melville, NY 11747-1512
Phone (631) 935-5388
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002882 | NY | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Audiology Distribution, LLC | Current | Accepting new patients |
Locations
355 Broadway
Amityville, NY 11701
Phone (631) 229-3100
355 Broadway
Ste 4
Amityville, NY 11701
Phone (631) 789-1794
73 E Old Country Rd
#A
Hicksville, NY 11801
Phone (516) 520-8736
1776 Broadway
New York, NY 10019
Phone (212) 399-7329
Organizations & group practices 1
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": "1557273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557273600000",
"number": "1073178729",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8 ELDERWOOD LN",
"city": "MELVILLE",
"state": "NY",
"postal_code": "117471512",
"telephone_number": "631-935-5388"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "73A E OLD COUNTRY RD",
"city": "HICKSVILLE",
"state": "NY",
"postal_code": "118014200",
"telephone_number": "516-520-8736",
"fax_number": "516-433-4840"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROTH",
"first_name": "COURTNEY",
"middle_name": "ANN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-08",
"last_updated": "2019-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Hicksville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2019; 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.