Individual provider Active NPI

Abigail Seagle Petty, AUD

  • Audiologist
  • Cedar Rapids, IA
National Provider Identifier
1164099305
Registry record updated Jun 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
108769 Issued in IA
Practice address
202 10TH St SE Ste 200
Cedar Rapids, IA 52403-2434
Phone
(319) 399-2022
NPI assigned
Jun 7, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 108769 IA Primary

Addresses

Primary practice location

202 10TH St SE Ste 200
Cedar Rapids, IA 52403-2434

Mailing address

20 S 41St St Apt 137
Council Bluffs, IA 51501-3371
Phone (828) 508-2962

Other names 1

  • Abigail Lora Seagle Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210616000847 IA Practitioner - Qualified Audiologist 7214337005 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
ENT Medical Services PCGroup PAC ID 7113819863, 8 clinicians

Practice addresses (Care Compare)

2615 Northgate Dr
Iowa City, IA 52245-9502
Phone (319) 351-5680

Merit-based Incentive Payment System (MIPS)

Final score
83.5 of 100Reported as group
Quality
68.67
Promoting interoperability
100
Improvement activities
40
Cost
76.34

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
108769IAMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians' Clinic of Iowa, PC CurrentSince Jun 21, 2021 Accepting new patients
Physicians Clinic of Iowa, PC CurrentSince Jun 21, 2021 Accepting new patients
ENT Medical Services PC CurrentSince Feb 10, 2025 Accepting new patients
Pruchno Medicine, LLC PastSince Jun 15, 2021 Accepting new patients

Locations

202 10th St SE
Cedar Rapids, IA 52403
Phone (319) 247-3010

202 10th St SE
Ste 165
Cedar Rapids, IA 52403
Phone (319) 247-3049

202 10th St SE
Ste 200
Cedar Rapids, IA 52403
Phone (319) 247-3899

2615 Northgate Dr
Iowa City, IA 52245
Phone (319) 337-6879

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JIJCBD

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": "1623024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623024000000",
    "number": "1164099305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 S 41ST ST APT 137",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515013371",
            "telephone_number": "828-508-2962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 10TH ST SE STE 200",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524032434",
            "telephone_number": "319-399-2022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTY",
        "first_name": "ABIGAIL",
        "middle_name": "SEAGLE",
        "name_prefix": "Dr.",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-07",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IA",
            "license": "108769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ABIGAIL",
            "last_name": "SEAGLE",
            "middle_name": "LORA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cedar Rapids, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2021; 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.