Individual provider Active NPI

Jennifer Ann Detsch, AU.D.

  • Audiologist
  • Saint Marys, PA
National Provider Identifier
1396898938
Registry record updated Feb 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AT-005892 Issued in PA
Practice address
20 N Michael St
Saint Marys, PA 15857-1394
Phone
(814) 834-7721
NPI assigned
Jan 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AT-005892 PA Primary

Addresses

Primary practice location

20 N Michael St
Saint Marys, PA 15857-1394

Mailing address

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060309000114 PA Practitioner - Qualified Audiologist 0143235655 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AT-005892PAMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Keystone Audiology & Hearing AIDS, Inc. Audiologist CurrentSince Feb 1, 2019 Accepting new patients

Locations

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

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": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551225600000",
    "number": "1396898938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1095 MILLION DOLLAR HWY",
            "address_2": "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": "20 N MICHAEL ST",
            "city": "SAINT MARYS",
            "state": "PA",
            "postal_code": "158571394",
            "telephone_number": "814-834-7721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETSCH",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2019-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "PA",
            "license": "AT-005892",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 27, 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.