Individual provider Active NPI

Maria Veronica Vivas, M.SCCC-A

  • Audiologist
  • Milford, MA
National Provider Identifier
1174720106
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
604 Issued in MA
Practice address
215 West St
Milford, MA 01757-2277
Phone
(508) 478-0723
NPI assigned
Jul 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 604 MA Primary

Addresses

Primary practice location

215 West St
Milford, MA 01757-2277

Mailing address

215 West St
Milford, MA 01757-2277
Phone (508) 478-0723

Other identifiers 1

IdentifierTypeStateIssuer
5102944MedicaidMA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101112000629 MA Practitioner - Qualified Audiologist 5092894816 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

215 W St
Milford, MA 01757-2277
Phone (508) 478-0723

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Milford Audiology Center Inc CurrentSince Jun 12, 2002 Accepting new patients
Northeastern University Past Accepting new patients
Northeastern University Audiologist Past Accepting new patients

Locations

215 West St
Milford, MA 01757
Phone (508) 478-6226

Organizations & group practices 3

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": "1183334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174720106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 WEST ST",
            "city": "MILFORD",
            "state": "MA",
            "postal_code": "017572277",
            "telephone_number": "508-478-0723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 WEST ST",
            "city": "MILFORD",
            "state": "MA",
            "postal_code": "017572277",
            "telephone_number": "508-478-0723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIVAS",
        "first_name": "MARIA",
        "middle_name": "VERONICA",
        "name_prefix": "Mrs.",
        "credential": "M.SCCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MA",
            "license": "604",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5102944",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, MA

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.
  • 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.