Individual provider Active NPI

Renee Andrzejewski, AU.D.,CCC-A

  • Audiologist
  • Olean, NY
National Provider Identifier
1417956541
Registry record updated Jan 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
001168 Issued in NY
Practice address
2223 W State St
Suite 102
Olean, NY 14760-1938
Phone
(716) 372-7205
Fax
(716) 372-4792
NPI assigned
Jul 20, 2005
Last updated
Jan 15, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 001168 NY Primary

Addresses

Primary practice location

2223 W State St
Suite 102
Olean, NY 14760-1938

Mailing address

2223 W State St
Suite 102
Olean, NY 14760-1938
Phone (716) 372-7205

Other identifiers 1

IdentifierTypeStateIssuer
01111706MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Great Lakes Hearing Services Inc PastSince May 19, 2008 Accepting new patients

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, 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": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231977600000",
    "number": "1417956541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2223 W STATE ST",
            "address_2": "SUITE 102",
            "city": "OLEAN",
            "state": "NY",
            "postal_code": "147601938",
            "telephone_number": "716-372-7205",
            "fax_number": "716-372-4792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2223 W STATE ST",
            "address_2": "SUITE 102",
            "city": "OLEAN",
            "state": "NY",
            "postal_code": "147601938",
            "telephone_number": "716-372-7205",
            "fax_number": "716-372-4792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDRZEJEWSKI",
        "first_name": "RENEE",
        "credential": "AU.D.,CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-20",
        "last_updated": "2009-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NY",
            "license": "001168",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01111706",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olean, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.