Mackenzie Broadbent Thomas, AUD

Primary specialty

AudiologistTaxonomy code 231H00000X

License

51599 Issued in TX

Practice address

172 Creekside Park Rd Ste 107
Spring Branch, TX 78070-6226

Phone

(830) 438-7766

Fax

(830) 438-6110

NPI assigned

Aug 27, 2007

Last updated

Mar 2, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Qualified Audiologist

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Altitude Audiology LLCGroup PAC ID 7911239975, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Altitude Audiology, LLC

  • Audiologist
  • Spring Branch, TX
  • NPI 1326690470
  Medicare reassignment Care Compare group NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1188172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677715200000",
    "number": "1164615753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "172 CREEKSIDE PARK RD STE 107",
            "city": "SPRING BRANCH",
            "state": "TX",
            "postal_code": "780706226",
            "telephone_number": "830-438-7766",
            "fax_number": "830-468-6110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "172 CREEKSIDE PARK RD STE 107",
            "city": "SPRING BRANCH",
            "state": "TX",
            "postal_code": "780706226",
            "telephone_number": "830-438-7766",
            "fax_number": "830-438-6110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "MACKENZIE",
        "middle_name": "BROADBENT",
        "credential": "AUD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-27",
        "last_updated": "2023-03-02",
        "certification_date": "2021-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "TX",
            "license": "51599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jesus Alfredo Torres, PA-C

• Audiologist in Spring Branch, TX
• Providers in Spring Branch, TX by specialty
• Audiologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2023; 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.