Organization Active NPI

Keystone Audiology & Hearing AIDS, Inc.

  • Audiologist
  • Saint Marys, PA
National Provider Identifier
1396201323
Registry record updated Feb 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
Legal business name
KEYSTONE AUDIOLOGY & HEARING AIDS, INC.
Practice address
1095 Million Dollar Hwy Ste 2
Saint Marys, PA 15857-2743
Phone
(814) 834-7721
NPI assigned
Feb 14, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2019

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

Authorized official

Name
Jennifer Detsch, AUDNPI 1396898938
Title
President
Phone
(814) 834-7721

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
AudiologistGroup: 193400000X SINGLE SPECIALTY GROUP 231H00000X Primary

Addresses

Primary practice location

1095 Million Dollar Hwy Ste 2
Saint Marys, PA 15857-2743

Mailing address

1095 Million Dollar Hwy Ste 2
Saint Marys, PA 15857-2743
Phone (814) 834-7721

Other identifiers 1

IdentifierTypeStateIssuer
13968938MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190425000129 PA Part B Supplier - Clinic/Group Practice 0749522662 Receives reassigned benefits from 1 practitioner
Practice locations: Saint Marys, PA

National Provider Directory

National Provider Directory

Locations

1095 Million Dollar Hwy
Ste 2
Saint Marys, PA 15857
Phone (814) 834-7721

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1550102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550102400000",
    "number": "1396201323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1095 MILLION DOLLAR HWY STE 2",
            "city": "SAINT MARYS",
            "state": "PA",
            "postal_code": "158572743",
            "telephone_number": "814-834-7721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1095 MILLION DOLLAR HWY STE 2",
            "city": "SAINT MARYS",
            "state": "PA",
            "postal_code": "158572743",
            "telephone_number": "814-834-7721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYSTONE AUDIOLOGY & HEARING AIDS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-14",
        "last_updated": "2019-02-14",
        "status": "A",
        "authorized_official_last_name": "DETSCH",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "814-834-7721",
        "authorized_official_credential": "AUD"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "13968938",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Marys, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2019; 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.