NPIMap

Organization Active NPI

Hackensack Audiology and Hearing Aid Associates, LLC

  • Audiologist
  • Hackensack, NJ
National Provider Identifier
1194973818
Registry record updated Sep 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
41YA00057700 Issued in NJ
Legal business name
HACKENSACK AUDIOLOGY AND HEARING AID ASSOCIATES, LLC
Practice address
20 Prospect Ave
Suite 808
Hackensack, NJ 07601-1997
Phone
(914) 261-3147
NPI assigned
Sep 6, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2008

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

Authorized official

Name
Dr. Kenneth Alan Bodkin, AU.D.NPI 1427199140
Title
Coo
Phone
(914) 261-3147

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
AudiologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 231H00000X 41YA00057700 NJ Primary
Assistive Technology Practitioner AudiologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 231HA2400X 41YA00057700 NJ
Assistive Technology Supplier AudiologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 231HA2500X 41YA00057700 NJ
Audiologist-Hearing Aid FitterGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 237600000X 25MG00090100 NJ

Addresses

Primary practice location

20 Prospect Ave
Suite 808
Hackensack, NJ 07601-1997

Mailing address

20 Prospect Ave
Suite 808
Hackensack, NJ 07601-1997

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090325000542 NJ Part B Supplier - Clinic/Group Practice 7214094846 Receives reassigned benefits from 6 practitioners
Practice locations: Hackensack, NJ

National Provider Directory

National Provider Directory
Tax ID family
Hackensack Audiology and Hearing Aid Associates LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1220659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220659200000",
    "number": "1194973818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 PROSPECT AVE",
            "address_2": "SUITE 808",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 PROSPECT AVE",
            "address_2": "SUITE 808",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011997",
            "telephone_number": "914-261-3147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HACKENSACK AUDIOLOGY AND HEARING AID ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-06",
        "last_updated": "2008-09-06",
        "status": "A",
        "authorized_official_last_name": "BODKIN",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "914-261-3147",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "AU.D."
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Audiologist",
            "state": "NJ",
            "license": "41YA00057700",
            "primary": true
        },
        {
            "code": "231HA2400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Audiologist, Assistive Technology Practitioner",
            "state": "NJ",
            "license": "41YA00057700",
            "primary": false
        },
        {
            "code": "231HA2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Audiologist, Assistive Technology Supplier",
            "state": "NJ",
            "license": "41YA00057700",
            "primary": false
        },
        {
            "code": "237600000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "NJ",
            "license": "25MG00090100",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.