Active NPI
Sacred Heart University
- Audiologist
- Bridgeport, CT
National Provider Identifier
1609373588
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 552
- Legal business name
- SACRED HEART UNIVERSITY
- Practice address
- 4000 Park Ave
Bridgeport, CT 06604-1047 - Phone
- (203) 396-6895
- NPI assigned
- Apr 9, 2018
- Last updated
- May 4, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Office Manager, AUD
- Title
- Manager
- Phone
- (203) 396-6895
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 552 | CT | Primary |
Addresses
Primary practice location
4000 Park Ave
Bridgeport, CT 06604-1047
Mailing address
5151 Park Ave
Fairfield, CT 06825-1090
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180629000123 | CT | Part B Supplier - Clinic/Group Practice | 8123278348 | Practice locations: Bridgeport, CT |
National Provider Directory
National Provider DirectoryLocations
4000 Park Ave
Bridgeport, CT 06604
Phone (860) 567-6720
5151 Park Ave
#J
Fairfield, CT 06825
7 Cambridge Dr
Trumbull, CT 06611
Phone (203) 396-8042
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1523232000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1777852800000",
"number": "1609373588",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5151 PARK AVE",
"city": "FAIRFIELD",
"state": "CT",
"postal_code": "068251090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4000 PARK AVE",
"city": "BRIDGEPORT",
"state": "CT",
"postal_code": "066041047",
"telephone_number": "203-396-6895"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SACRED HEART UNIVERSITY",
"organizational_subpart": "NO",
"enumeration_date": "2018-04-09",
"last_updated": "2026-05-04",
"certification_date": "2026-05-04",
"status": "A",
"authorized_official_last_name": "MANAGER",
"authorized_official_first_name": "OFFICE",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "203-396-6895",
"authorized_official_credential": "AUD"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Audiologist",
"state": "CT",
"license": "552",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bridgeport, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.