Kevin Kristalovich, AUD, CCC-A

Primary specialty

AudiologistTaxonomy code 231H00000X

License

DA2024 Issued in AZ

Practice address

2700 N 140TH Ave
Ste 107
Goodyear, AZ 85395

Phone

(623) 535-8770

Fax

(623) 535-8771

NPI assigned

May 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Specialty

Qualified Audiologist

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Ear Nose and Throat Associates PCGroup PAC ID 2163407453, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Advanced Ear Nose and Throat Associates PC

  • Otolaryngology Physician
  • Phoenix, AZ
  • NPI 1235120411
  Medicare reassignment Care Compare group NPD
• Arizona Balance and Hearing Associates,LLC

  • Neurology Physician
  • Phoenix, AZ
  • NPI 1902195779
  NPD (past)
• Valley ENT, PC

  • Otolaryngology Physician
  • Scottsdale, AZ
  • NPI 1508990185
  NPD (past)
• Audiology Distribution, LLC

  • Audiologist-Hearing Aid Fitter
  • Dublin, OH
  • NPI 1164707998
  NPD (past)
• Hearusa Inc

  • Audiologist-Hearing Aid Fitter
  • West Palm Beach, FL
  • NPI 1073560231
  NPD (past)

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384300800000",
    "number": "1083665798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12550",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154016",
            "telephone_number": "623-535-8770",
            "fax_number": "623-535-8771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 N 140TH AVE",
            "address_2": "STE 107",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "85395",
            "telephone_number": "623-535-8770",
            "fax_number": "623-535-8771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRISTALOVICH",
        "first_name": "KEVIN",
        "name_prefix": "Mr.",
        "credential": "AUD, CCC-A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2013-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "AZ",
            "license": "DA2024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "948929",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bridgette Anne Kovar, FNP-C
• Amanda Kowalsky, PT, DPT
• Donald Charles Kraft, NURSE PRACTITIONER
• Nicholas King Kratzer
• Jane Krause
• Amy Joan Kristensen
• Adam Kristevski
• Merz Krom
• Yasmeen Kronz
• Crystal Krueger, LMFT

• Audiologist in Goodyear, AZ
• Providers in Goodyear, AZ by specialty
• Audiologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 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.