Active NPI
Kimberly Ann Sacco, AU.D
- Audiologist
- Mexico, NY
National Provider Identifier
1609367689
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 011881
- Practice address
- 179 County Route 64
Mexico, NY 13114-4219 - Phone
- (315) 569-0368
- NPI assigned
- May 24, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 011881 | NY | Primary |
Addresses
Primary practice location
179 County Route 64
Mexico, NY 13114-4219
Mailing address
179 County Route 64
Mexico, NY 13114
Phone (315) 569-0368
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 011881 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1527120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580947200000",
"number": "1609367689",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "179 COUNTY ROUTE 64",
"city": "MEXICO",
"state": "NY",
"postal_code": "13114",
"telephone_number": "315-569-0368"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "179 COUNTY ROUTE 64",
"city": "MEXICO",
"state": "NY",
"postal_code": "131144219",
"telephone_number": "315-569-0368"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SACCO",
"first_name": "KIMBERLY",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "AU.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-24",
"last_updated": "2020-02-06",
"certification_date": "2020-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "NY",
"license": "011881",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mexico, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.