Individual provider Active NPI

Tanya Marie McCormack, AUD

  • Audiologist
  • Washington, MO
National Provider Identifier
1144227356
Registry record updated Aug 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
2004015328 Issued in MO
Practice address
1713 Madison Ave Ste 200
Washington, MO 63090-4914
Phone
(636) 390-6020
Fax
(636) 390-6021
NPI assigned
Jul 1, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 2004015328 MO Primary

Addresses

Primary practice location

1713 Madison Ave Ste 200
Washington, MO 63090-4914

Mailing address

1713 Madison Ave Ste 200
Washington, MO 63090-4914
Phone (636) 390-6020

Other practice location 1

901 Patients First Dr
Washington, MO 63090-4700
Phone (636) 390-1570

Other identifiers 3

IdentifierTypeStateIssuer
1144227356MedicaidMO
P01152556OtherMORAILROAD MEDICARE
P00461427OtherRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080124000208 MO Practitioner - Qualified Audiologist 4486736899 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washington Hearing Center, LLCGroup PAC ID 7911324207, 2 clinicians

Practice addresses (Care Compare)

1713 Madison Ave
Suite 200
Washington, MO 63090-4914
Phone (636) 390-6020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Hearing Center, LLC CurrentSince Aug 25, 2020 Accepting new patients

Locations

1713 Madison Ave
Ste 200
Washington, MO 63090
Phone (636) 390-6020

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": "1120176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754265600000",
    "number": "1144227356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1713 MADISON AVE STE 200",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630904914",
            "telephone_number": "636-390-6020",
            "fax_number": "636-390-6021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1713 MADISON AVE STE 200",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630904914",
            "telephone_number": "636-390-6020",
            "fax_number": "636-390-6021"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "901 Patients First Dr",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "MO",
            "postal_code": "630904700",
            "country_code": "US",
            "telephone_number": "636-390-1570",
            "fax_number": "636-390-1571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCORMACK",
        "first_name": "TANYA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-01",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MO",
            "license": "2004015328",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1144227356",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01152556",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00461427",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2025; 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.