Individual provider Active NPI

Jennifer Ann Klimczak, AUD

  • Audiologist-Hearing Aid Fitter
  • Sacramento, CA
National Provider Identifier
1194126524
Registry record updated May 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Audiologist-Hearing Aid FitterTaxonomy code 237600000X
License
AU3124 Issued in CA
Practice address
1555 River Park Dr Ste 206L
Sacramento, CA 95815-4604
Phone
(916) 921-6023
Fax
(916) 921-1492
NPI assigned
Sep 4, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid Fitter 237600000X HT9090 CA
Audiologist-Hearing Aid Fitter 237600000X AU3124 CA Primary

Addresses

Primary practice location

1555 River Park Dr Ste 206L
Sacramento, CA 95815-4604

Mailing address

215 Shuman Blvd Ste 401
Naperville, IL 60563-8123
Phone (630) 303-5380

Other practice location 1

807 Douglas Blvd Ste 100
Roseville, CA 95678-2763
Phone (916) 773-9148

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

State licenses

LicenseStateTypeSpecialty
AU3124CAMDAudiologist-Hearing Aid Fitter
HT9090CAMDAudiologist-Hearing Aid Fitter

Practice roles

OrganizationSpecialtyStatusNew patients
Connect Hearing, Inc. Audiologist-Hearing Aid Fitter Past Accepting new patients
Connect Hearing, Inc. Audiologist-Hearing Aid Fitter Past Accepting new patients
Connect Hearing, Inc. Audiologist-Hearing Aid Fitter PastSince Dec 28, 2022 Accepting new patients
Connect Hearing, Inc. Audiologist-Hearing Aid Fitter PastSince Dec 16, 2020 Accepting new patients
Connect Hearing, Inc. Audiologist-Hearing Aid Fitter Past Accepting new patients
Connect Hearing, Inc. Audiologist-Hearing Aid Fitter Past Accepting new patients

Organizations & group practices 6

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": "1409788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525132800000",
    "number": "1194126524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 SHUMAN BLVD STE 401",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605638123",
            "telephone_number": "630-303-5380",
            "fax_number": "630-303-5385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 RIVER PARK DR STE 206L",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958154604",
            "telephone_number": "916-921-6023",
            "fax_number": "916-921-1492"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "807 Douglas Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Roseville",
            "state": "CA",
            "postal_code": "956782763",
            "country_code": "US",
            "telephone_number": "916-773-9148",
            "fax_number": "916-773-9150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KLIMCZAK",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-04",
        "last_updated": "2018-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "CA",
            "license": "HT9090",
            "primary": false
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "CA",
            "license": "AU3124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 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.