Individual provider Active NPI

Marisa L Madonna-Jones

  • Audiologist
  • Syracuse, NY
National Provider Identifier
1639358377
Registry record updated Oct 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
001265 Issued in NY
Practice address
406 University Ave
Syracuse, NY 13210-1803
Phone
(315) 472-4701
Fax
(315) 471-0411
NPI assigned
Oct 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 001265 NY Primary

Addresses

Primary practice location

406 University Ave
Syracuse, NY 13210-1803

Mailing address

406 University Ave
Syracuse, NY 13210-1803
Phone (315) 472-4701

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
001265NYMDNutritionist

Practice roles

OrganizationSpecialtyStatusNew patients
Ear, Nose & Throat Associates of Syracuse, P.C. Past Accepting new patients

Organizations & group practices 1

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": "1193702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193702400000",
    "number": "1639358377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 UNIVERSITY AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101803",
            "telephone_number": "315-472-4701",
            "fax_number": "315-471-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 UNIVERSITY AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101803",
            "telephone_number": "315-472-4701",
            "fax_number": "315-471-0411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADONNA-JONES",
        "first_name": "MARISA",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-30",
        "last_updated": "2007-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NY",
            "license": "001265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.