Individual provider Active NPI

Benjamin J Pickart, HIS

  • Hearing Instrument Specialist
  • Appleton, WI
National Provider Identifier
1487076378
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Instrument SpecialistTaxonomy code 237700000X
License
1431 - 60 Issued in WI
Practice address
654 W Ridgeview Dr Ste 2
Appleton, WI 54911-1254
Phone
(920) 364-9791
NPI assigned
Jan 10, 2014
Sex
Male
Sole proprietor
No

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid Fitter 237600000X WI
Hearing Instrument Specialist 237700000X 1431 - 60 WI Primary

Addresses

Primary practice location

654 W Ridgeview Dr Ste 2
Appleton, WI 54911-1254

Mailing address

8800 SE Sunnyside Rd Ste 300N
Clackamas, OR 97015-5703
Phone (281) 286-2999

Other practice location 1

481 E Division St
Suite 900
Fond Du Lac, WI 54935-3748
Phone (920) 926-1288

Other practice location 2

481 E Division St
Suite 900
Fond Du Lac, WI 54935-3748
Phone (920) 926-1288

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1431 - 60WIMDHearing Instrument Specialist

NPI Registry JSON

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

{
    "created_epoch": "1389312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1487076378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8800 SE SUNNYSIDE RD STE 300N",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970155703",
            "telephone_number": "281-286-2999",
            "fax_number": "512-607-4893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "654 W RIDGEVIEW DR STE 2",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549111254",
            "telephone_number": "920-364-9791"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "481 E Division St",
            "address_2": "Suite 900",
            "address_purpose": "LOCATION",
            "city": "Fond Du Lac",
            "state": "WI",
            "postal_code": "549353748",
            "country_code": "US",
            "telephone_number": "920-926-1288",
            "fax_number": "920-926-0533",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "481 E Division St",
            "address_2": "Suite 900",
            "address_purpose": "LOCATION",
            "city": "Fond Du Lac",
            "state": "WI",
            "postal_code": "549353748",
            "country_code": "US",
            "telephone_number": "920-926-1288",
            "fax_number": "920-926-0533",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PICKART",
        "first_name": "BENJAMIN",
        "middle_name": "J",
        "credential": "HIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-01-10",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "WI",
            "license": null,
            "primary": false
        },
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "WI",
            "license": "1431 - 60",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.