Individual provider Active NPI

Marissa Mae Gilger, AUD

  • Audiologist-Hearing Aid Fitter
  • Vallejo, CA
National Provider Identifier
1629625439
Registry record updated Oct 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Audiologist-Hearing Aid FitterTaxonomy code 237600000X
License
AU3451 Issued in CA
Practice address
1761 Broadway St Ste 200
Vallejo, CA 94589-2227
Phone
(707) 645-2500
NPI assigned
Aug 26, 2019
Sex
Female
Sole proprietor
No

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.

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kimberly Bonney Aud Inc 7 clinicians

Practice addresses (Care Compare)

101 Margaret LN
Suite C
Grass Valley, CA 95945-4207
Phone (530) 477-8114

Medicare participation

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

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20201110002318 CA Practitioner - Qualified Audiologist 6507276169 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AU3451CAMDAudiologist-Hearing Aid Fitter

Practice roles

OrganizationSpecialtyStatusNew patients
Kimberly Bonney Aud, Inc Audiologist-Hearing Aid Fitter CurrentSince Oct 1, 2020 Accepting new patients
Audiology Specialty Clinics of Ca, Inc Audiologist-Hearing Aid Fitter PastSince Mar 5, 2023 Accepting new patients

Locations

4944 Windplay Dr
Ste 120
El Dorado Hills, CA 95762
Phone (530) 461-0080

457 Sutton Way
Grass Valley, CA 95945
Phone (530) 264-8838

101 Margaret Ln
Ste C
Grass Valley, CA 95945
Phone (530) 272-2244

1101 W Tokay St
Ste 4
Lodi, CA 95240
Phone (209) 368-9222

6000 Fairway Dr
Ste 15
Rocklin, CA 95677
Phone (916) 315-8114

601 University Ave
Ste 105
Sacramento, CA 95825
Phone (916) 927-9640

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid Fitter 237600000X AU3451 CA Primary

Addresses

NPPES NPI Registry

Primary practice location

1761 Broadway St Ste 200
Vallejo, CA 94589-2227

Mailing address

457 Sutton Way
Grass Valley, CA 95945-4102
Phone (530) 477-8114

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 26, 2020.

{
    "created_epoch": "1566777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1629625439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "457 SUTTON WAY",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959454102",
            "telephone_number": "530-477-8114",
            "fax_number": "530-477-1513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1761 BROADWAY ST STE 200",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945892227",
            "telephone_number": "707-645-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILGER",
        "first_name": "MARISSA",
        "middle_name": "MAE",
        "name_prefix": "Dr.",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-26",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "CA",
            "license": "AU3451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vallejo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2020; 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.