Individual provider Active NPI

Andrea Soltis Kristalovich, AU.D.

  • Audiologist-Hearing Aid Fitter
  • Glendale, AZ
National Provider Identifier
1144488388
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Audiologist-Hearing Aid FitterTaxonomy code 237600000X
License
DA2019 Issued in AZ
Practice address
5750 W Thunderbird Rd
A-100
Glendale, AZ 85306-4660
Phone
(602) 938-3205
Fax
(602) 938-5799
NPI assigned
May 23, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid Fitter 237600000X DA2019 AZ Primary

Addresses

Primary practice location

5750 W Thunderbird Rd
A-100
Glendale, AZ 85306-4660

Mailing address

4530 E Shea Blvd Ste 180
Phoenix, AZ 85028-6042
Phone (602) 264-4834

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080908000464 AZ Practitioner - Qualified Audiologist 3173699600 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Honorhealth AmbulatoryGroup PAC ID 5991603110, 630 clinicians
Arizona Otolaryngology Consultants, PCGroup PAC ID 5294621868, 22 clinicians

Practice addresses (Care Compare)

10510 N 92ND St
Scottsdale, AZ 85258-4566

5750 W Thunderbird Rd
Suite A100
Glendale, AZ 85306-4661
Phone (602) 938-3205

Merit-based Incentive Payment System (MIPS)

Final score
79.69 of 100Reported as group
Quality
73.68
Improvement activities
40
Cost
67.39

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Audiology Distribution, LLC Audiologist-Hearing Aid Fitter Past Accepting new patients
Hearusa Inc Audiologist-Hearing Aid Fitter Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: andrea.kristalovich.1@24142.direct.athenahealth.com

Organizations & group practices 4

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": "1211500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1144488388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4530 E SHEA BLVD STE 180",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850286042",
            "telephone_number": "602-264-4834",
            "fax_number": "602-254-5178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5750 W THUNDERBIRD RD",
            "address_2": "A-100",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064660",
            "telephone_number": "602-938-3205",
            "fax_number": "602-938-5799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRISTALOVICH",
        "first_name": "ANDREA",
        "middle_name": "SOLTIS",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-23",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "AZ",
            "license": "DA2019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2024; 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.