Individual provider Active NPI

Susan R Marek, AU.D., CCC-A

  • Audiologist
  • Melbourne, FL
National Provider Identifier
1326182510
Registry record updated Oct 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AY2145 Issued in FL
Practice address
1314 Pine St
Melbourne, FL 32901-3117
Phone
(321) 802-6697
NPI assigned
Feb 19, 2007
Last updated
Oct 10, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AY2145 FL Primary

Addresses

Primary practice location

1314 Pine St
Melbourne, FL 32901-3117

Mailing address

1314 Pine St
Melbourne, FL 32901-3117
Phone (321) 802-6697

Other identifiers 1

IdentifierTypeStateIssuer
AY2145OtherFLLICENSED AUDIOLOGIST

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171031001559 FL Practitioner - Qualified Audiologist 7618199191 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Ear Nose Throat Allergy Sinus LLC CurrentSince Aug 31, 2017 Accepting new patients
The Nemours Foundation Past Accepting new patients

Locations

1314 Pine St
Melbourne, FL 32901
Phone (321) 728-8400

Organizations & group practices 2

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": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507593600000",
    "number": "1326182510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1314 PINE ST",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013117",
            "telephone_number": "321-802-6697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1314 PINE ST",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013117",
            "telephone_number": "321-802-6697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAREK",
        "first_name": "SUSAN",
        "middle_name": "R",
        "credential": "AU.D., CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-19",
        "last_updated": "2017-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "FL",
            "license": "AY2145",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED AUDIOLOGIST",
            "identifier": "AY2145",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2017; 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.