Individual provider Active NPI

Kelly Anders, AUD

  • Audiologist
  • Jenkintown, PA
National Provider Identifier
1669369187
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AT007031 Issued in PA
Practice address
1077 Rydal Rd
Jenkintown, PA 19046-1712
Phone
(844) 570-1767
NPI assigned
Jun 18, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AT007031 PA Primary

Addresses

Primary practice location

1077 Rydal Rd
Jenkintown, PA 19046-1712

Mailing address

416 8TH Ave
East Northport, NY 11731-2119

Other practice location 1

3509 N Broad St
Philadelphia, PA 19140-4105
Phone (844) 570-1767

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250702002897 PA Practitioner - Qualified Audiologist 3577076413 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Temple Faculty Practice Plan IncGroup PAC ID 0345588711, 1,325 clinicians

Practice addresses (Care Compare)

3509 N Broad St
Philadelphia, PA 19140-4105
Phone (215) 707-8484

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AT007031PAMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Faculty Practice Plan Inc Audiologist CurrentSince May 12, 2025 Accepting new patients
Temple Faculty Practice Plan Inc CurrentSince May 12, 2025 Accepting new patients
Temple Faculty Practice Plan Inc Current Accepting new patients

Locations

3509 N Broad St
Philadelphia, PA 19140
Phone (215) 707-2433

3401 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3807

1077 Rydal Rd
Rydal, PA 19046
Phone (215) 707-7300

Organizations & group practices 3

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": "1750204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750204800000",
    "number": "1669369187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 8TH AVE",
            "city": "EAST NORTHPORT",
            "state": "NY",
            "postal_code": "117312119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1077 RYDAL RD",
            "city": "JENKINTOWN",
            "state": "PA",
            "postal_code": "190461712",
            "telephone_number": "844-570-1767"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3509 N Broad St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191404105",
            "country_code": "US",
            "telephone_number": "844-570-1767",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERS",
        "first_name": "KELLY",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-18",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "PA",
            "license": "AT007031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jenkintown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2025; 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.