Individual provider Active NPI

Kamal A. Elliot, AU.D.

  • Specialist
  • Willow Street, PA
National Provider Identifier
1639139223
Registry record updated Oct 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
AT001094L Issued in PA
Practice address
226 Willow Valley Lakes Dr
Suite D
Willow Street, PA 17584-9665
Phone
(717) 464-2144
Fax
(717) 464-4255
NPI assigned
Mar 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X AT001094L PA Primary
Specialist 174400000X AY1669 FL

Addresses

Primary practice location

226 Willow Valley Lakes Dr
Suite D
Willow Street, PA 17584-9665

Mailing address

1555 Highlands Dr
Suite 101
Lititz, PA 17543-2800
Phone (717) 627-4327

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041123000276 PA Practitioner - Qualified Audiologist 6002871670 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
A and E Audiology, Inc.Group PAC ID 4486752870, 7 clinicians

Practice addresses (Care Compare)

235 Bloomfield Dr
Suite 108
Lititz, PA 17543-7792
Phone (717) 336-8198

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AT001094LPAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Hearing Smile Professionals LLC CurrentSince Jan 1, 2025 Accepting new patients
A & E Audiology, Inc. CurrentSince Jan 1, 2007 Accepting new patients
A&E Audiology and Hearing Aid Center Past Accepting new patients
A&E Audiology and Hearing Aid Center Past Accepting new patients

Locations

2160 Noll Dr
Ste 100
Lancaster, PA 17603
Phone (717) 392-4327

235 Bloomfield Dr
Ste 108
Lititz, PA 17543
Phone (717) 336-8198

1555 Highlands Dr
Ste 101
Lititz, PA 17543
Phone (717) 627-4327

3 Cardinal Dr
Stevens, PA 17578
Phone (717) 336-1224

226 Willow Valley Lakes Dr
Ste D
Willow Street, PA 17584
Phone (717) 464-2144

325 Carol Lynn Dr
Willow Street, PA 17584
Phone (717) 464-0230

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349913600000",
    "number": "1639139223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 HIGHLANDS DR",
            "address_2": "SUITE 101",
            "city": "LITITZ",
            "state": "PA",
            "postal_code": "175432800",
            "telephone_number": "717-627-4327",
            "fax_number": "717-627-2690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 WILLOW VALLEY LAKES DR",
            "address_2": "SUITE D",
            "city": "WILLOW STREET",
            "state": "PA",
            "postal_code": "175849665",
            "telephone_number": "717-464-2144",
            "fax_number": "717-464-4255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOT",
        "first_name": "KAMAL",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-27",
        "last_updated": "2012-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PA",
            "license": "AT001094L",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "AY1669",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willow Street, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2012; 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.