Aviva Kagan
Individual provider Active NPI Audiologist · Mineola, NY
NPI 1104907443 · NPPES record last updated Jun 2, 2008
Key facts
- NPI
- 1104907443
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Audiologist 231H00000X
- License
- 001536-1 (NY)
- Practice address
- 354 E Jericho Tpke
Mineola, NY 11501-2135 - Phone
- (516) 741-3000
- NPI assigned
- Oct 17, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- 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
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080407000219 | NY | Practitioner - Qualified Audiologist | 5092892653 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001536 | NY | MD | Marriage & Family Therapist |
| 001536-1 | NY | MD | Audiologist |
Practice roles (2 of 6)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alk Hearing LLC | Current |
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 H9678
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 001536-1 | NY | Yes |
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
Other providers in Mineola, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 2, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.