Active NPI
Mary G. Capozzelli, M.S.
- Audiologist
- Ridgewood, NJ
National Provider Identifier
1174558704
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 41YA00017000
- Practice address
- 323 Northern Pkwy
Ridgewood, NJ 07450-2626 - Phone
- (201) 447-1883
- Fax
- (201) 857-8558
- NPI assigned
- Jul 12, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 41YA00017000 | NJ | Primary |
| Audiologist | 231H00000X | 000306-1 | NY |
Addresses
Primary practice location
323 Northern Pkwy
Ridgewood, NJ 07450-2626
Mailing address
323 Northern Pkwy
Ridgewood, NJ 07450-2626
Phone (201) 447-1883
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000306 | NY | MD | Psychoanalyst |
| 000306-1 | NY | MD | Audiologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dhac, Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Hearing Instrument Specialist
- Central Islip, NY
- NPI 1174643571
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1174558704",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "323 NORTHERN PKWY",
"city": "RIDGEWOOD",
"state": "NJ",
"postal_code": "074502626",
"telephone_number": "201-447-1883",
"fax_number": "201-857-8558"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "323 NORTHERN PKWY",
"city": "RIDGEWOOD",
"state": "NJ",
"postal_code": "074502626",
"telephone_number": "201-447-1883",
"fax_number": "201-857-8558"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAPOZZELLI",
"first_name": "MARY",
"middle_name": "G.",
"name_prefix": "Ms.",
"credential": "M.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "NJ",
"license": "41YA00017000",
"primary": true
},
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "NY",
"license": "000306-1",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ridgewood, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.