Ismaly Lorenzo-Matias, AU.D.
Individual provider Active NPI Audiologist · Aguada, PR
NPI 1154712263 · NPPES record last updated Jan 27, 2023
Key facts
- NPI
- 1154712263
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Audiologist 231H00000X
- License
- 1024 (PR)
- Practice address
- 1813 Bo Asomante
Aguada, PR 00602-2405 - Phone
- (305) 904-3649
- NPI assigned
- Feb 11, 2015
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Qualified Audiologist
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
94 Calle Colon
Aguada, PR 00602-3115
Phone (305) 904-3649
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230315000184 | PR | Practitioner - Qualified Audiologist | 4486971082 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AY 1919 | FL | MD | Audiologist |
| 1024 | PR | MD | Speech-Language Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oimos PSC | Audiologist | Current |
Accepting new patients |
| Hearusa Inc | Past |
Accepting new patients | |
| Greater Miami Ear Associates LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | AY 1919 | FL | |
| Audiologist | 231H00000X | 1024 | PR | Yes |
Addresses
Primary practice location
1813 Bo Asomante
Aguada, PR 00602-2405
Mailing address
1813 Bo Asomante
Aguada, PR 00602-2405
Phone (305) 904-3649
Other providers in Aguada, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 27, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.