Organization Active NPI

Forest Hills Audiology PC

  • Audiologist-Hearing Aid Fitter
  • Forest Hills, NY
National Provider Identifier
1083005797
Registry record updated Feb 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Audiologist-Hearing Aid FitterTaxonomy code 237600000X
License
002511-1 Issued in NY
Legal business name
FOREST HILLS AUDIOLOGY PC
Practice address
11011 72ND Ave
Ste 1B
Forest Hills, NY 11375-4910
Phone
(718) 577-2235
Fax
(347) 229-9000
NPI assigned
Feb 17, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2016

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

Authorized official

Name
Dr. Roksana Borukhova, AU.DNPI 1457749392
Title
Adiologist/Owner
Phone
(347) 409-8958

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid FitterGroup: 193400000X SINGLE SPECIALTY GROUP 237600000X 002511-1 NY Primary

Addresses

Primary practice location

11011 72ND Ave
Ste 1B
Forest Hills, NY 11375-4910

Mailing address

11011 72ND Ave
Ste 1B
Forest Hills, NY 11375-4910
Phone (718) 577-2235

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160205001651 NY Part B Supplier - Clinic/Group Practice 7618271974 Receives reassigned benefits from 1 practitioner
Practice locations: Forest Hills, NY; Woodside, NY

National Provider Directory

National Provider Directory

Locations

11011 72nd Ave
Ste 1B
Forest Hills, NY 11375
Phone (718) 261-9000

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1424131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455062400000",
    "number": "1083005797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11011 72ND AVE",
            "address_2": "STE 1B",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113754910",
            "telephone_number": "718-577-2235",
            "fax_number": "347-229-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11011 72ND AVE",
            "address_2": "STE 1B",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113754910",
            "telephone_number": "718-577-2235",
            "fax_number": "347-229-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOREST HILLS AUDIOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-17",
        "last_updated": "2016-02-10",
        "status": "A",
        "authorized_official_last_name": "BORUKHOVA",
        "authorized_official_first_name": "ROKSANA",
        "authorized_official_title_or_position": "ADIOLOGIST/OWNER",
        "authorized_official_telephone_number": "347-409-8958",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "AU.D"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "NY",
            "license": "002511-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2016; 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.

Verify at the official NPI Registry.