Individual provider Active NPI

Mary Krista Blasetti, AUD CCC A

  • Audiologist
  • York, PA
National Provider Identifier
1356515688
Registry record updated Mar 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AT006165 Issued in PA
Practice address
924 Colonial Ave
York, PA 17403-3450
Phone
(717) 843-9089
Fax
(717) 843-6075
NPI assigned
Apr 17, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid Fitter 237600000X DA5353 AZ
Audiologist 231H00000X AT006165 PA Primary

Addresses

Primary practice location

924 Colonial Ave
York, PA 17403-3450

Mailing address

601 Memory LN
York, PA 17402-2231

Other practice location 1

1227 Baltimore St
Hanover, PA 17331-4406
Phone (717) 339-3120

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101217000286 PA Practitioner - Qualified Audiologist 9537234935 Reassigns benefits to 2 organizations

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
Wellspan Medical GroupGroup PAC ID 1951213115, 2,438 clinicians

Practice addresses (Care Compare)

924 Colonial Ave
York, PA 17403-3450
Phone (717) 843-9089

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspan Medical Group CurrentSince Dec 12, 2021 Accepting new patients
York ENT Associates CurrentSince Sep 24, 2010 Accepting new patients
Wellspan Medical Group Current Accepting new patients
Wellspan Hearing Center Inc Audiologist CurrentSince Sep 24, 2010 Accepting new patients
Wellspan Medical Group CurrentSince Dec 12, 2021 Accepting new patients
Advanced Ear Nose and Throat Associates PC PastSince Oct 1, 2002 Accepting new patients
Valley ENT, PC Past Accepting new patients

Locations

1227 Baltimore St
Hanover, PA 17331
Phone (717) 646-4204

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

1600 S George St
York, PA 17403
Phone (717) 848-3615

924 Colonial Ave
York, PA 17403
Phone (717) 668-0339

601 Memory Ln
York, PA 17402
Phone (717) 851-6670

924 Colonial Ave
Ste E
York, PA 17403
Phone (717) 843-9089

3421 Concord Rd
York, PA 17402
Phone (717) 851-2441

Organizations & group practices 7

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": "1208390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1356515688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 MEMORY LN",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174022231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "924 COLONIAL AVE",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174033450",
            "telephone_number": "717-843-9089",
            "fax_number": "717-843-6075"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1227 Baltimore St",
            "address_purpose": "LOCATION",
            "city": "Hanover",
            "state": "PA",
            "postal_code": "173314406",
            "country_code": "US",
            "telephone_number": "717-339-3120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLASETTI",
        "first_name": "MARY",
        "middle_name": "KRISTA",
        "name_prefix": "Mrs.",
        "credential": "AUD CCC A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-17",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "AZ",
            "license": "DA5353",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "PA",
            "license": "AT006165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in York, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2025; 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.