Individual provider Active NPI

Stacy J Weasen, AU.D.

  • Audiologist
  • Voorhees, NJ
National Provider Identifier
1528490158
Registry record updated Oct 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
41YA00106600 Issued in NJ
Practice address
1000 White Horse Rd Ste 510
Voorhees, NJ 08043-4411
Phone
(856) 627-4400
NPI assigned
Aug 6, 2013
Last updated
Oct 29, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 002485-1 NY
Audiologist 231H00000X 41YA00106600 NJ Primary

Addresses

Primary practice location

1000 White Horse Rd Ste 510
Voorhees, NJ 08043-4411

Mailing address

1002 S Colorado St
Philadelphia, PA 19146-1910
Phone (954) 673-0820

Other practice location 1

775 Route 70 E Ste F120B
Marlton, NJ 08053-2358
Phone (856) 797-1414

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200205002601 NJ Practitioner - Qualified Audiologist 0749616084 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
41YA00106600NJMDAudiologist
002485-1NYMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Audiology Services Company USA, LLC Audiologist Current Accepting new patients
Rem Audiology Associates, P.C. Audiologist CurrentSince Oct 1, 2019 Accepting new patients
Audiology Services Company USA, LLC CurrentSince Oct 1, 2019 Accepting new patients
Audiology Services Company USA, LLC CurrentSince Oct 1, 2019 Accepting new patients

Locations

138 Village Center Dr
Unit B4
Freehold, NJ 07728
Phone (732) 683-1140

775 Route 70 E
Ste F120B
Marlton, NJ 08053
Phone (856) 797-1414

2501 Cottontail Ln
Somerset, NJ 08873
Phone (732) 529-7120

1000 White Horse Rd
Ste 510
Voorhees, NJ 08043
Phone (856) 627-4400

Organizations & group practices 4

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": "1375747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572307200000",
    "number": "1528490158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 S COLORADO ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191461910",
            "telephone_number": "954-673-0820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 WHITE HORSE RD STE 510",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080434411",
            "telephone_number": "856-627-4400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "775 Route 70 E Ste F120B",
            "address_purpose": "LOCATION",
            "city": "Marlton",
            "state": "NJ",
            "postal_code": "080532358",
            "country_code": "US",
            "telephone_number": "856-797-1414",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEASEN",
        "first_name": "STACY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-06",
        "last_updated": "2019-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NY",
            "license": "002485-1",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NJ",
            "license": "41YA00106600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Voorhees, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.