Staci Elizabeth Petralba, AU.D.

Primary specialty

AudiologistTaxonomy code 231H00000X

License

A-2261 Issued in NV

Practice address

401 N Buffalo Dr Ste 120
Las Vegas, NV 89145-0397

Phone

(702) 880-1515

NPI assigned

Jul 1, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Island Audiology, LLC

  • Audiologist
  • Honolulu, HI
  • NPI 1811948045
  NPD (past)

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

{
    "created_epoch": "1435708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1184007692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 N BUFFALO DR STE 120",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891450397",
            "telephone_number": "702-880-1515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 N BUFFALO DR STE 120",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891450397",
            "telephone_number": "702-880-1515"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "73-5618 Maiau St Ste A203",
            "address_purpose": "LOCATION",
            "city": "Kailua Kona",
            "state": "HI",
            "postal_code": "967402634",
            "country_code": "US",
            "telephone_number": "808-329-0943",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETRALBA",
        "first_name": "STACI",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-01",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "HI",
            "license": "AUD 153",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NV",
            "license": "A-2261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zachary Peterson
• Yoana Lubenova Peteva, MD
• Petit CM Investments LLC
• India Petitt
• Jakob Petitt
• Jean-Pierre Petrel II, PA-C
• Joanne Marie Petrelli, APRN
• Zona Petrelli, LCSW, CSW-G
• Crystal L Petrello, RD
• Mia Rose Petri

• Audiologist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Audiologist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.