Individual provider Active NPI

Alexis Noel Staudenmeier, AUD

  • Audiologist
  • Philadelphia, PA
National Provider Identifier
1548870793
Registry record updated Aug 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AT006711 Issued in PA
Practice address
205 N Broad St Ste 401
Philadelphia, PA 19107-1553
Phone
(215) 762-4600
NPI assigned
Aug 3, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AT006711 PA Primary

Addresses

Primary practice location

205 N Broad St Ste 401
Philadelphia, PA 19107-1553

Mailing address

171 Grape St Apt 202
Philadelphia, PA 19127-1455
Phone (240) 446-4337

Other practice location 1

8350 Roosevelt Blvd Ste 1
Philadelphia, PA 19152-2531
Phone (215) 331-6878

Other practice location 2

5501 Old York Rd Fl Paley2
Philadelphia, PA 19141-3018
Phone (215) 456-7140

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200812003517 PA Practitioner - Qualified Audiologist 4183040850 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Otolaryngology Associates PCGroup PAC ID 0941299895, 9 clinicians

Practice addresses (Care Compare)

205 N Broad St
Suite 401
Philadelphia, PA 19107-1553
Phone (215) 762-4600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fornance Physician Services, Inc. CurrentSince Sep 1, 2021 Accepting new patients
University Otolaryngology Associates PC CurrentSince Aug 6, 2020 Accepting new patients
Fornance Physician Services, Inc. CurrentSince Sep 1, 2021 Accepting new patients
Fornance Physician Services, Inc Current Accepting new patients

Locations

210 Mall Blvd
Ste 102
Kng of Prussa, PA 19406
Phone (610) 265-0726

8350 Roosevelt Blvd
Ste 1
Philadelphia, PA 19152
Phone (215) 331-6878

205 N Broad St
Ste 401
Philadelphia, PA 19107
Phone (215) 569-3155

5501 Old York Rd
Ste 2
Philadelphia, PA 19141
Phone (215) 456-7130

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1596412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596412800000",
    "number": "1548870793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 GRAPE ST APT 202",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191271455",
            "telephone_number": "240-446-4337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N BROAD ST STE 401",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191071553",
            "telephone_number": "215-762-4600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8350 Roosevelt Blvd Ste 1",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191522531",
            "country_code": "US",
            "telephone_number": "215-331-6878",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5501 Old York Rd Fl Paley2",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191413018",
            "country_code": "US",
            "telephone_number": "215-456-7140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAUDENMEIER",
        "first_name": "ALEXIS",
        "middle_name": "NOEL",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-03",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "PA",
            "license": "AT006711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2020; 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.