Individual provider Active NPI

Susanna Storm, AU.D

  • Audiologist-Hearing Aid Fitter
  • Berkeley, CA
National Provider Identifier
1124350426
Registry record updated Dec 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Audiologist-Hearing Aid FitterTaxonomy code 237600000X
License
AU-2766 Issued in CA
Practice address
3017 Telegraph Ave
Ste. 230
Berkeley, CA 94705
Phone
(415) 314-7272
NPI assigned
Feb 11, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2015

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 2007014895 MO
Audiologist-Hearing Aid Fitter 237600000X AU-2766 CA Primary

Addresses

Primary practice location

3017 Telegraph Ave
Ste. 230
Berkeley, CA 94705

Mailing address

3017 Telegraph Ave
Ste. 230
Berkeley, CA 94705
Phone (415) 314-7272

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130514000288 CA Practitioner - Qualified Audiologist 7517099294 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3017 Telegraph Ave
Suite 230
Berkeley, CA 94705-2049
Phone (510) 540-9000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2007014895MOMDAudiologist-Hearing Aid Fitter

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Sky Hearing & Audiology, Inc. Audiologist-Hearing Aid Fitter CurrentSince Feb 1, 2016 Accepting new patients

Locations

3017 Telegraph Ave
Ste 230
Berkeley, CA 94705
Phone (415) 314-7272

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1265846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451347200000",
    "number": "1124350426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3017 TELEGRAPH AVE",
            "address_2": "STE. 230",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "94705",
            "telephone_number": "415-314-7272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3017 TELEGRAPH AVE",
            "address_2": "STE. 230",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "94705",
            "telephone_number": "415-314-7272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STORM",
        "first_name": "SUSANNA",
        "name_prefix": "Dr.",
        "credential": "AU.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-11",
        "last_updated": "2015-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "MO",
            "license": "2007014895",
            "primary": false
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "CA",
            "license": "AU-2766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2015; 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.