Individual provider Active NPI

Joanna Roufos, AU.D,CCC-A

  • Audiologist
  • Whitestone, NY
National Provider Identifier
1073778700
Registry record updated Feb 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
001479-1 Issued in NY
Practice address
15012 14TH Ave
Suite 200
Whitestone, NY 11357-1800
Phone
(718) 279-4327
Fax
(718) 279-1281
NPI assigned
Jul 22, 2008
Last updated
Feb 25, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 001479-1 NY Primary
Audiologist-Hearing Aid Fitter 237600000X 14000022298 NY

Addresses

Primary practice location

15012 14TH Ave
Suite 200
Whitestone, NY 11357-1800

Mailing address

15012 14TH Ave
Suite 200
Whitestone, NY 11357-1800
Phone (718) 279-4327

Other identifiers 1

IdentifierTypeStateIssuer
03164174MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091120000057 NY Practitioner - Qualified Audiologist 4284773805 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

15012 14TH Ave
Suite 200
Whitestone, NY 11357-1800
Phone (718) 279-4327

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001479NYMDAcupuncturist
001479-1NYMDAudiologist
14000022298NYMDAudiologist-Hearing Aid Fitter

Practice roles

OrganizationSpecialtyStatusNew patients
Queens Audiology, PLLC Audiologist CurrentSince Sep 10, 2009 Accepting new patients
Manhattan Audiology Past Accepting new patients
Queens Audiology, PLLC Audiologist Past Accepting new patients
Queens Audiology, PLLC Audiologist PastSince Sep 10, 2009 Accepting new patients

Locations

3016 30th Dr
Long Island City, NY 11102
Phone (718) 728-3376

210 E 64th St
Fl 3
New York, NY 10065
Phone (212) 434-4050

1421 3rd Ave
Apt 4
New York, NY 10028
Phone (212) 452-1500

121 E 84th St
New York, NY 10028
Phone (212) 792-3900

1421 3rd Ave
New York, NY 10028
Phone (212) 744-5538

210 E 64th St
New York, NY 10065
Phone (212) 434-4312

15012 14th Ave
Ste 200
Whitestone, NY 11357
Phone (718) 279-4327

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": "1216684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361750400000",
    "number": "1073778700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15012 14TH AVE",
            "address_2": "SUITE 200",
            "city": "WHITESTONE",
            "state": "NY",
            "postal_code": "113571800",
            "telephone_number": "718-279-4327",
            "fax_number": "718-279-1281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15012 14TH AVE",
            "address_2": "SUITE 200",
            "city": "WHITESTONE",
            "state": "NY",
            "postal_code": "113571800",
            "telephone_number": "718-279-4327",
            "fax_number": "718-279-1281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUFOS",
        "first_name": "JOANNA",
        "credential": "AU.D,CCC-A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-22",
        "last_updated": "2013-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NY",
            "license": "001479-1",
            "primary": true
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "NY",
            "license": "14000022298",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03164174",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Whitestone, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2013; 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.