Individual provider Active NPI

Patrick John Obrien, AUD

  • Audiologist
  • Port St Lucie, FL
National Provider Identifier
1124230990
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
FL Issued in FL
Practice address
567 SW Indian Key Dr
Port St Lucie, FL 34986-2053
Phone
(772) 240-5429
NPI assigned
May 4, 2007
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X FL FL Primary

Addresses

Primary practice location

567 SW Indian Key Dr
Port St Lucie, FL 34986-2053

Mailing address

567 SW Indian Key Dr
Port St Lucie, FL 34986-2053
Phone (772) 240-5429

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090113000436 NC Practitioner - Qualified Audiologist 9931147840 Reassigns benefits to 1 organization
I20240722003813 TX Practitioner - Qualified Audiologist 9931147840 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8005NCMDProfessional Counselor
FLFLMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Maniilaq Association CurrentSince Jul 1, 2024 Accepting new patients
Maniilaq Association CurrentSince Jul 1, 2024 Accepting new patients
ENT and Allergy Associates of Florida, LLC Past Accepting new patients
DRS Berghash & Lanza PL PastSince Apr 2, 2001 Accepting new patients
Campbell Ear, Nose & Throat, PA Past Accepting new patients
Audiological Communcation Consultants,LLC Past Accepting new patients
Wake Audiology & Hearing Aid Associates, PLLC Audiologist PastSince May 2, 2005 Accepting new patients
Vrooman Audiology, PLLC Audiologist PastSince May 1, 2019 Accepting new patients

Organizations & group practices 9

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": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1124230990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "567 SW INDIAN KEY DR",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349862053",
            "telephone_number": "772-240-5429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "567 SW INDIAN KEY DR",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349862053",
            "telephone_number": "772-240-5429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBRIEN",
        "first_name": "PATRICK",
        "middle_name": "JOHN",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-04",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "FL",
            "license": "FL",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.