Individual provider Active NPI

Jessica Katelyn Woodson

  • Audiologist
  • Scarsdale, NY
National Provider Identifier
1366950495
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
0027381 Issued in NY
Practice address
688A White Plains Rd
Scarsdale, NY 10583-5008
Phone
(914) 472-4444
Fax
(914) 472-4444
NPI assigned
Jan 10, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 0027381 NY Primary

Addresses

Primary practice location

688A White Plains Rd
Scarsdale, NY 10583-5008

Mailing address

688A White Plains Rd
Scarsdale, NY 10583-5008
Phone (646) 589-0342

Other practice location 1

1036 Park Ave Ste 1B
New York, NY 10028-0971
Phone (212) 879-3836

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201214002535 NY Practitioner - Qualified Audiologist 5991117079 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Audio Help Associates, Inc.Group PAC ID 1850448051, 6 clinicians

Practice addresses (Care Compare)

1036 Park Ave
1B
New York, NY 10028-0971
Phone (212) 879-3836

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0027381NYMDAudiologist

Organizations & group practices 1

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": "1515542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1366950495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "688A WHITE PLAINS RD",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "105835008",
            "telephone_number": "646-589-0342",
            "fax_number": "917-893-6487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "688A WHITE PLAINS RD",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "105835008",
            "telephone_number": "914-472-4444",
            "fax_number": "914-472-4444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1036 Park Ave Ste 1B",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100280971",
            "country_code": "US",
            "telephone_number": "212-879-3836",
            "fax_number": "917-893-6487",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOODSON",
        "first_name": "JESSICA",
        "middle_name": "KATELYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-10",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NY",
            "license": "0027381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scarsdale, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.