Individual provider Active NPI

Dana L.. Oviatt, PH.D.

  • Audiologist
  • Syracuse, NY
National Provider Identifier
1508855891
Registry record updated Jan 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
001163 Issued in NY
Practice address
1001 James St
Syracuse, NY 13203-2707
Phone
(315) 428-0016
Fax
(315) 478-3913
NPI assigned
Oct 19, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 001163 NY Primary

Addresses

Primary practice location

1001 James St
Syracuse, NY 13203-2707

Mailing address

109 Marangale Rd
Manlius, NY 13104-1008
Phone (315) 682-2993

Other identifiers 2

IdentifierTypeStateIssuer
01368309MedicaidNY
J400043589OtherNYMEDICARE PTAN

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
Credentials
Doctor of Philosophy

NPI Registry JSON

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

{
    "created_epoch": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326412800000",
    "number": "1508855891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 MARANGALE RD",
            "city": "MANLIUS",
            "state": "NY",
            "postal_code": "131041008",
            "telephone_number": "315-682-2993",
            "fax_number": "315-478-3913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 JAMES ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132032707",
            "telephone_number": "315-428-0016",
            "fax_number": "315-478-3913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OVIATT",
        "first_name": "DANA",
        "middle_name": "L..",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-19",
        "last_updated": "2012-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NY",
            "license": "001163",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01368309",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "J400043589",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2012; 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.