Individual provider Active NPI

Walter Dick Beck

  • Audiologist-Hearing Aid Fitter
  • Cerritos, CA
National Provider Identifier
1104873033
Registry record updated May 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Audiologist-Hearing Aid FitterTaxonomy code 237600000X
License
AU1794 Issued in CA
Practice address
10929 South St
Ste 202B
Cerritos, CA 90703-5340
Phone
(562) 860-1504
NPI assigned
May 27, 2006
Last updated
May 28, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid Fitter 237600000X AU1794 CA Primary
Hearing Instrument Specialist 237700000X HA4147 CA

Addresses

Primary practice location

10929 South St
Ste 202B
Cerritos, CA 90703-5340

Mailing address

5912 Bolsa Ave
Ste 201
Huntington Beach, CA 92649-1146
Phone (714) 898-5732

Other identifiers 1

IdentifierTypeStateIssuer
AU0017940MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061101000501 CA Practitioner - Qualified Audiologist 2365449592 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AU1794CAMDAudiologist-Hearing Aid Fitter
HA4147CAMDHearing Instrument Specialist
1794CAMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Sonus-USA, Inc. Audiologist-Hearing Aid Fitter PastSince Apr 8, 2016 Accepting new patients
Adapt Hearing Inc Past Accepting new patients

Organizations & group practices 3

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": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401235200000",
    "number": "1104873033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5912 BOLSA AVE",
            "address_2": "STE 201",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926491146",
            "telephone_number": "714-898-5732",
            "fax_number": "714-901-4058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10929 SOUTH ST",
            "address_2": "STE 202B",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907035340",
            "telephone_number": "562-860-1504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECK",
        "first_name": "WALTER",
        "middle_name": "DICK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-27",
        "last_updated": "2014-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "CA",
            "license": "AU1794",
            "primary": true
        },
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "CA",
            "license": "HA4147",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AU0017940",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cerritos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2014; 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.