Peter Jansen Marincovich, PHD AUDIOLOGIST DISP

Primary specialty

AudiologistTaxonomy code 231H00000X

License

AU758 Issued in CA

Practice address

1111 Sonoma Avenue
Suite 316
Santa Rosa, CA 95405

Phone

(707) 523-4740

Fax

(707) 523-0231

NPI assigned

Nov 30, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Qualified Audiologist

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Audiology Associates

  • Hearing and Speech Clinic/Center
  • Novato, CA
  • NPI 1003171638
  NPD (past) Authorized official
• Peter J Marincovich

  dba Audiology Associates

  • Audiologist
  • Santa Rosa, CA
  • NPI 1417044801
  NPD (past) Authorized official
• Peter J. Marincovich

  dba Audiology Associates

  • Hearing and Speech Clinic/Center
  • Mendocino, CA
  • NPI 1275888976
  NPD (past) Authorized official
• Peter J. Marincovich

  dba Audiology Associates

  • Hearing and Speech Clinic/Center
  • Mill Valley, CA
  • NPI 1881949535
  NPD (past) Authorized official
• St. Joseph Health Northern California, LLC

  dba Providence Santa Rosa Memorial Hospital

  • General Acute Care Hospital
  • Santa Rosa, CA
  • NPI 1134152549
  NPD (past)

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363132800000",
    "number": "1447327507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 SONOMA AVENUE",
            "address_2": "SUITE 316",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "95405",
            "telephone_number": "707-523-4740",
            "fax_number": "707-523-0231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 SONOMA AVENUE",
            "address_2": "SUITE 316",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "95405",
            "telephone_number": "707-523-4740",
            "fax_number": "707-523-0231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARINCOVICH",
        "first_name": "PETER",
        "middle_name": "JANSEN",
        "credential": "PHD AUDIOLOGIST DISP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2013-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "CA",
            "license": "AU758",
            "primary": true
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "CA",
            "license": "HA1949",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AU0007580",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ03361Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRM",
            "identifier": "640002077",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ03362Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marin Apothecaries (Vista Clinic Pharmacy)
• Marin Apothecaries (Lombardi Rosa Pharmacy)
• Marin Apothecaries (Dutton Community Pharmacy)
• Marin Medical Laboratories
• Anna Irene Marincovich, PT
• Mercedes C Mariolle
• Marian Ivarsson Marioni, PSYD
• Jamie Mariscal
• Marisha Chilcott MD Inc
• Michael Armand Maritzen

• Audiologist in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Audiologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2013; 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.