Individual provider Active NPI

Avni Patankar, AU.D

  • Audiologist
  • Cumming, GA
National Provider Identifier
1558633719
Registry record updated Dec 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AUD003896 Issued in GA
Practice address
407 E Maple St Ste 306
Cumming, GA 30040-2657
Phone
(404) 375-5363
NPI assigned
Feb 3, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 2788 CA
Audiologist 231H00000X AUD003896 GA Primary

Addresses

Primary practice location

407 E Maple St Ste 306
Cumming, GA 30040-2657

Mailing address

407 E Maple St Ste 306
Cumming, GA 30040-2657
Phone (404) 375-5363

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120319000027 GA Practitioner - Qualified Audiologist 1355500919 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
East Tennessee State University Quillen College of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

407 E Maple St
Suite 306
Cumming, GA 30040-2657
Phone (404) 375-5363

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2788CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Maple Hearing Clinic LLC Audiologist CurrentSince Dec 13, 2023 Accepting new patients
The Emory Clinic Inc CurrentSince May 28, 2018 Accepting new patients

Locations

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

407 E Maple St
Ste 306
Cumming, GA 30040
Phone (404) 375-5363

Organizations & group practices 2

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": "1328227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703203200000",
    "number": "1558633719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 E MAPLE ST STE 306",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300402657",
            "telephone_number": "404-375-5363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 E MAPLE ST STE 306",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300402657",
            "telephone_number": "404-375-5363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATANKAR",
        "first_name": "AVNI",
        "credential": "AU.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-03",
        "last_updated": "2023-12-22",
        "certification_date": "2023-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "CA",
            "license": "2788",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "GA",
            "license": "AUD003896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2023; 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.