Individual provider Active NPI

Constance Nicole Metropulos, AU.D

  • Audiologist
  • Plantation, FL
National Provider Identifier
1669733440
Registry record updated Sep 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AY2082 Issued in FL
Practice address
220 SW 84TH Ave
Suite 101
Plantation, FL 33324-2754
Phone
(954) 476-0400
Fax
(954) 473-6673
NPI assigned
Jun 7, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assistive Technology Supplier Audiologist 231HA2500X 002403-1 NY
Audiologist 231H00000X AY2082 FL Primary

Addresses

Primary practice location

220 SW 84TH Ave
Suite 101
Plantation, FL 33324-2754

Mailing address

220 SW 84TH Ave
Suite 101
Plantation, FL 33324-2754
Phone (954) 476-0400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170119000587 FL Practitioner - Qualified Audiologist 9931331881 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
ENT and Allergy Associates of Florida, LLCGroup PAC ID 0042292849, 227 clinicians

Practice addresses (Care Compare)

220 SW 84TH Ave
Suite 101
Plantation, FL 33324-2729
Phone (954) 476-0400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002403NYMDMarriage & Family Therapist
AY2082FLMDAudiologist
002403-1NYMDAssistive Technology Supplier Audiologist

Practice roles

OrganizationSpecialtyStatusNew patients
ENT and Allergy Associates of Florida, LLC CurrentSince Oct 15, 2016 Accepting new patients
Ear,Nose,Throat & Facial Plastic Surgery Center,of South Florida, P.a. PastSince Oct 15, 2016 Accepting new patients

Locations

6421 Congress Ave
Ste 113
Boca Raton, FL 33487
Phone (561) 338-3267

900 NW 13th St
Ste 206
Boca Raton, FL 33486
Phone (561) 338-3267

220 SW 84th Ave
Ste 101
Plantation, FL 33324
Phone (954) 476-0400

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.

NPI Registry JSON

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

{
    "created_epoch": "1339027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473897600000",
    "number": "1669733440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 SW 84TH AVE",
            "address_2": "SUITE 101",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333242754",
            "telephone_number": "954-476-0400",
            "fax_number": "954-473-6673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 SW 84TH AVE",
            "address_2": "SUITE 101",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333242754",
            "telephone_number": "954-476-0400",
            "fax_number": "954-473-6673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "METROPULOS",
        "first_name": "CONSTANCE",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "AU.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-07",
        "last_updated": "2016-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231HA2500X",
            "taxonomy_group": "",
            "desc": "Audiologist, Assistive Technology Supplier",
            "state": "NY",
            "license": "002403-1",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "FL",
            "license": "AY2082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2016; 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.