Individual provider Active NPI

Aviva Kagan

  • Audiologist
  • Mineola, NY
National Provider Identifier
1104907443
Registry record updated Jun 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
001536-1 Issued in NY
Practice address
354 E Jericho Tpke
Mineola, NY 11501-2135
Phone
(516) 741-3000
NPI assigned
Oct 17, 2006
Last updated
Jun 2, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 001536-1 NY Primary

Addresses

Primary practice location

354 E Jericho Tpke
Mineola, NY 11501-2135

Mailing address

354 E Jericho Tpke
Mineola, NY 11501-2135
Phone (516) 741-3000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080407000219 NY Practitioner - Qualified Audiologist 5092892653 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8715 37TH Ave
Suite D
Jackson Heights, NY 11372-7733
Phone (718) 507-5200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001536-1NYMDMetabolic Nutrition Registered Dietitian
001536NYMDArt Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Alk Hearing LLC CurrentSince Apr 19, 2013 Accepting new patients
Hearusa Inc Past Accepting new patients

Locations

8715 37th Ave
Ste D
Jackson Heights, NY 11372
Phone (718) 507-5200

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 2

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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212364800000",
    "number": "1104907443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "354 E JERICHO TPKE",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115012135",
            "telephone_number": "516-741-3000",
            "fax_number": "718-627-0040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "354 E JERICHO TPKE",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115012135",
            "telephone_number": "516-741-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAGAN",
        "first_name": "AVIVA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2008-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NY",
            "license": "001536-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mineola, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2008; 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.