Active NPI
Susanna Storm, AU.D
- Audiologist-Hearing Aid Fitter
- Berkeley, CA
National Provider Identifier
1124350426
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist-Hearing Aid Fitter
- License
- AU-2766
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2007014895 | MO | MD | Audiologist-Hearing Aid Fitter |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Blue Sky Hearing & Audiology, Inc. | Audiologist-Hearing Aid Fitter | Current | 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.
-
- Audiologist-Hearing Aid Fitter
- Berkeley, CA
- NPI 1467817718
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.