Individual provider Active NPI

Lauren E Moss, AUD

  • Audiologist
  • Park Ridge, IL
National Provider Identifier
1255776209
Registry record updated May 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
147001463 Issued in IL
Practice address
2604 Dempster St Ste 501
Park Ridge, IL 60068-8429
Phone
(847) 674-5585
NPI assigned
May 3, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X
AudiologistGroup: 193400000X SINGLE SPECIALTY GROUP 231H00000X 147001463 IL Primary

Addresses

Primary practice location

2604 Dempster St Ste 501
Park Ridge, IL 60068-8429

Mailing address

1912 Halifax St
Libertyville, IL 60048-4334

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140929000125 IL Practitioner - Qualified Audiologist 8820218761 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest ENT Alliance PLLCGroup PAC ID 5294276259, 97 clinicians

Practice addresses (Care Compare)

2604 Dempster St
Suite 501
Park Ridge, IL 60068-8429
Phone (847) 674-5585

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
147001463ILMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Hearing Professionals of Il LTD Audiologist CurrentSince Apr 8, 2026 Accepting new patients
Ear, Nose & Throat Specialists of Illinois LTD Single Specialty CurrentSince Nov 5, 2021 Accepting new patients
Midwest ENT Alliance PLLC Single Specialty CurrentSince Feb 7, 2025 Accepting new patients
Bastian Voice Institute, LLC Single Specialty PastSince Sep 22, 2003 Accepting new patients

Locations

111 S Pfingsten Rd
Ste 106
Deerfield, IL 60015

3010 Highland Pkwy
Ste 550
Downers Grove, IL 60515
Phone (630) 724-1100

8780 W Golf Rd
Ste 200
Niles, IL 60714
Phone (847) 824-4390

2604 Dempster St
Ste 501
Park Ridge, IL 60068
Phone 8476745585111

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1367539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1255776209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1912 HALIFAX ST",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600484334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2604 DEMPSTER ST STE 501",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600688429",
            "telephone_number": "847-674-5585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSS",
        "first_name": "LAUREN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "AUD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-03",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Audiologist",
            "state": "IL",
            "license": "147001463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2024; 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.