Individual provider Active NPI

Wendy Wallach-Delucia, M.S.

  • Audiologist
  • Danbury, CT
National Provider Identifier
1164422903
Registry record updated Jan 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
000273 Issued in CT
Practice address
107 Newtown Rd
2A
Danbury, CT 06810-4146
Phone
(203) 830-4700
Fax
(203) 730-4166
NPI assigned
Jul 22, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 000273 CT Primary

Addresses

Primary practice location

107 Newtown Rd
2A
Danbury, CT 06810-4146

Mailing address

107 Newtown Rd
2A
Danbury, CT 06810-4146
Phone (203) 830-4700

Other identifiers 1

IdentifierTypeStateIssuer
004145464MedicaidCT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081212000003 CT Practitioner - Qualified Audiologist 5799846598 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
000273CTMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Specialty Care, P.C. CurrentSince Jan 23, 2010 Accepting new patients
Advanced Audiology & Hearing Aid Services Audiologist PastSince Jan 23, 2010 Accepting new patients

Locations

107 Newtown Rd
Ste 2A
Danbury, CT 06810
Phone (203) 830-4700

901 Ethan Allen Hwy
Ridgefield, CT 06877
Phone (203) 383-9967

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: wendy.wallachdeluciams.p1@direct.asc.nextgenshare.com

Organizations & group practices 2

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": "1121990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359417600000",
    "number": "1164422903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 NEWTOWN RD",
            "address_2": "2A",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068104146",
            "telephone_number": "203-830-4700",
            "fax_number": "203-730-4166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 NEWTOWN RD",
            "address_2": "2A",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068104146",
            "telephone_number": "203-830-4700",
            "fax_number": "203-730-4166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACH-DELUCIA",
        "first_name": "WENDY",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-22",
        "last_updated": "2013-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "CT",
            "license": "000273",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004145464",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.