Kellyanne Boylan, AU.D.

Primary specialty

AudiologistTaxonomy code 231H00000X

License

01610 Issued in MD

Practice address

1629 York Rd
Lutherville, MD 21093-5633

Phone

(443) 578-3900

NPI assigned

Jul 13, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Specialty

Qualified Audiologist

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Audiology Associates Inc.Group PAC ID 4981626389, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Audiology Associates Inc.

  dba Audiology Associates

  • Audiologist
  • Parkville, MD
  • NPI 1942325527
  Medicare reassignment Care Compare group NPD
• V. Patrick Mahat, M.D., P.C.

  • Otolaryngology Physician
  • Washington, DC
  • NPI 1922267897
  NPD (past)

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

{
    "created_epoch": "1657670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657670400000",
    "number": "1598499725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3615 E JOPPA RD STE 210",
            "city": "PARKVILLE",
            "state": "MD",
            "postal_code": "212343386",
            "telephone_number": "410-944-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1629 YORK RD",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210935633",
            "telephone_number": "443-578-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYLAN",
        "first_name": "KELLYANNE",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-13",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MD",
            "license": "01610",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AUDIOLOGY",
            "identifier": "1942325527",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephen E Boretzky, PTA
• Caroline Bos
• Robert Bradley Boughan, MD
• Joseph Blake Bourne III
• Kraig S Bower, M.D.
• Jordan Amber Bradford, OTD, OTR/L
• Hannah Michele Breckenridge
• June Elizabeth Breiner, M.D.
• Brent C. Birely, M.D., P.a.
• Susan B Bressler, M.D.

• Audiologist in Lutherville, MD
• Providers in Lutherville, MD by specialty
• Audiologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2022; 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.