Individual provider Active NPI

Ann Marie C Gentili-Stockwell, MA CCC-A

  • Audiologist
  • Chestnut Hill, MA
National Provider Identifier
1588649669
Registry record updated Feb 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
460 Issued in MA
Practice address
1244 Boylston St
Ste 303
Chestnut Hill, MA 02467
Phone
(617) 383-6830
Fax
(617) 383-6880
NPI assigned
Dec 12, 2005
Last updated
Feb 1, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 460 MA Primary

Addresses

Primary practice location

1244 Boylston St
Ste 303
Chestnut Hill, MA 02467

Mailing address

1244 Boylston St
Ste 303
Chestnut Hill, MA 02467-2116
Phone (617) 383-6841

Other identifiers 1

IdentifierTypeStateIssuer
AD0104OtherMABLUE CROSS BLUE SHIELD

Other names 1

  • Ms. Ann Stockwell Professional name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081017000443 MA Practitioner - Qualified Audiologist 9032277116 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vernick and Gopal,LLCGroup PAC ID 9537142302, 5 clinicians

Practice addresses (Care Compare)

1244 Boylston St
Suite 303
Chestnut Hill, MA 02467-2115
Phone (617) 383-6800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
460MAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Vernick & Gopal,LLC CurrentSince Apr 4, 2007 Accepting new patients
Cambridge Family Health North PastSince Apr 4, 2007 Accepting new patients

Locations

1244 Boylston St
Ste 303
Chestnut Hill, MA 02467
Phone (617) 383-6800

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, 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": "1134345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296518400000",
    "number": "1588649669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1244 BOYLSTON ST",
            "address_2": "STE 303",
            "city": "CHESTNUT HILL",
            "state": "MA",
            "postal_code": "024672116",
            "telephone_number": "617-383-6841",
            "fax_number": "617-383-6880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1244 BOYLSTON ST",
            "address_2": "STE 303",
            "city": "CHESTNUT HILL",
            "state": "MA",
            "postal_code": "02467",
            "telephone_number": "617-383-6830",
            "fax_number": "617-383-6880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENTILI-STOCKWELL",
        "first_name": "ANN MARIE",
        "middle_name": "C",
        "name_prefix": "Ms.",
        "credential": "MA CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-12",
        "last_updated": "2011-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MA",
            "license": "460",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "AD0104",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANN",
            "last_name": "STOCKWELL",
            "prefix": "MS.",
            "credential": "MA CCCA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Chestnut Hill, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2011; 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.