Individual provider Active NPI

Emily Jeannine Cossaboon, AUD

  • Audiologist
  • Rockville, MD
National Provider Identifier
1265685671
Registry record updated Jan 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
00991 Issued in MD
Practice address
9420 Key West Ave Ste 310
Rockville, MD 20850
Phone
(301) 315-5888
Fax
(301) 315-5866
NPI assigned
Oct 29, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 02-0000169 DE
Audiologist 231H00000X 00991 MD Primary

Addresses

Primary practice location

9420 Key West Ave Ste 310
Rockville, MD 20850

Mailing address

8400 Rosebay LN Apt 404
Manassas, VA 20109-3818
Phone (410) 530-1060

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130509000291 PA Practitioner - Qualified Audiologist 9133306731 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ear Nose and Throat Associates of Butler, LTDGroup PAC ID 7517904543, 4 clinicians

Practice addresses (Care Compare)

104 Technology Dr
Suite 102
Butler, PA 16001-1801
Phone (724) 782-0028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
02-0000169DEMDAudiologist
00991MDMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ear Nose & Throat Associates of Butler, LTD CurrentSince Jan 1, 2021 Accepting new patients
Ear, Nose & Throat Specialists of Shady Grove, P.C. PastSince Jan 1, 2022 Accepting new patients
Elk County Chiropractic, Inc. Past Accepting new patients

Locations

104 Technology Dr
Ste 102
Butler, PA 16001
Phone (724) 482-0028

Organizations & group practices 3

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": "1225238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546819200000",
    "number": "1265685671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8400 ROSEBAY LN APT 404",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201093818",
            "telephone_number": "410-530-1060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9420 KEY WEST AVE STE 310",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "20850",
            "telephone_number": "301-315-5888",
            "fax_number": "301-315-5866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSSABOON",
        "first_name": "EMILY",
        "middle_name": "JEANNINE",
        "name_prefix": "Dr.",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-29",
        "last_updated": "2019-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "DE",
            "license": "02-0000169",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MD",
            "license": "00991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2019; 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.