Pamela J Buethe
Individual provider Active NPI Audiologist · Washington, DC
NPI 1265600084 · NPPES record last updated Feb 14, 2008
Key facts
- NPI
- 1265600084
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Audiologist 231H00000X
- License
- 01022 (MD)
- Practice address
- 111 Michigan Ave NW
Washington, DC 20010-2978 - Phone
- (202) 476-5600
- Fax
- (202) 476-2163
- NPI assigned
- Feb 14, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220405000192 | CO | Practitioner - Qualified Audiologist | 8921494758 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01022 | MD | MD | Clinical Neuropsychologist |
| 2101001446 | VA | MD | Audiologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Audiology Distribution, LLC | Current |
Accepting new patients |
Locations
7850 Vance Dr
Ste 195
Arvada, CO 80003
Phone (303) 432-3601
7200 S Alton Way
Ste B140
Centennial, CO 80112
Phone (303) 649-2122
7325 S Pierce St
Ste 100
Littleton, CO 80128
Phone (303) 933-0017
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 01022 | MD | Yes |
| Audiologist | 231H00000X | 2101001446 | VA |
Addresses
Primary practice location
111 Michigan Ave NW
Washington, DC 20010-2978
Mailing address
111 Michigan Ave NW
Washington, DC 20010-2978
Phone (202) 476-5600
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0300140 | Medicaid | DC |
Other providers in Washington, DC
- Allyson Buennemeyer
- Reuben A Bueno
- Kirsten Buescher
- Teresa Marie Buescher
- Bridget Anne Buesing
- Michelle Buff
- Latasha Denise Bufford
- Edward Tipton Buford III
- Tiffany Bufort-Odom
- Erika Bugaj Petrova
All providers in Washington, DC · Audiologist in District of Columbia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 14, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.