Individual provider Active NPI

Jennifer M Krause, MA, CCC-A

  • Audiologist
  • Gilbert, AZ
National Provider Identifier
1073820106
Registry record updated Mar 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
DA4551 Issued in AZ
Practice address
2680 S Val Vista Dr
BLDG 13, Unit 175
Gilbert, AZ 85295-2152
Phone
(480) 784-0110
Fax
(480) 784-0220
NPI assigned
Sep 10, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X DA4551 AZ Primary

Addresses

Primary practice location

2680 S Val Vista Dr
BLDG 13, Unit 175
Gilbert, AZ 85295-2152

Mailing address

2680 S Val Vista Dr
BLDG 13, Unit 175
Gilbert, AZ 85295-2152
Phone (480) 784-0110

Other identifiers 1

IdentifierTypeStateIssuer
1073820106OtherMEDICARE NPI

Other names 1

  • Ms. Jennifer M Donnelly Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110112000126 AZ Practitioner - Qualified Audiologist 2961691670 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley ENT PCGroup PAC ID 8729149711, 70 clinicians

Practice addresses (Care Compare)

2081 W Frye Rd
Suite 100
Chandler, AZ 85224-6278
Phone (480) 753-1459

9097 E Desert Cove Ave
Suite 250
Scottsdale, AZ 85260-6278
Phone (480) 847-1193

Merit-based Incentive Payment System (MIPS)

Final score
83.58 of 100Reported as group
Quality
71.49
Promoting interoperability
100
Improvement activities
40
Cost
73.79

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Valley ENT, PC Past Accepting new patients
Northern Arizona Ear Nose and Throat PC PastSince Sep 1, 2001 Accepting new patients
Desert Valley ENT, PC Past Accepting new patients

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": "1284076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298937600000",
    "number": "1073820106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2680 S VAL VISTA DR",
            "address_2": "BLDG 13, UNIT 175",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852952152",
            "telephone_number": "480-784-0110",
            "fax_number": "480-784-0220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2680 S VAL VISTA DR",
            "address_2": "BLDG 13, UNIT 175",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852952152",
            "telephone_number": "480-784-0110",
            "fax_number": "480-784-0220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAUSE",
        "first_name": "JENNIFER",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "MA, CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-10",
        "last_updated": "2011-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "AZ",
            "license": "DA4551",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NPI",
            "identifier": "1073820106",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "DONNELLY",
            "middle_name": "M",
            "prefix": "MS.",
            "credential": "MA, CCC-A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2011; 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.