Individual provider Active NPI

Alexa T Kozak, AU.D.

  • Audiologist
  • Burlington, MA
National Provider Identifier
1679694137
Registry record updated May 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
822 Issued in MA
Practice address
Lahey Clinic
41 Mall Rd.
Burlington, MA 01805-0001
Phone
(781) 744-8452
Fax
(781) 744-3440
NPI assigned
Apr 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 822 MA Primary

Addresses

Primary practice location

Lahey Clinic
41 Mall Rd.
Burlington, MA 01805-0001

Mailing address

Lahey Clinic
41 Mall Rd.
Burlington, MA 01805-0001
Phone (781) 744-8452

Other identifiers 1

IdentifierTypeStateIssuer
822OtherMALICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081216000721 MA Practitioner - Qualified Audiologist 8022170687 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
822MAMDCommunity/Behavioral Health Agency

Practice roles

OrganizationSpecialtyStatusNew patients
New England Ear Nose and Throat LLC CurrentSince Sep 16, 2022 Accepting new patients
Bumc Otolaryngologic Foundation, Inc. Past Accepting new patients

Locations

2000 Washington St
Ste 544
Newton Lower Falls, MA 02462
Phone (617) 910-0368

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": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369958400000",
    "number": "1679694137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "LAHEY CLINIC",
            "address_2": "41 MALL RD.",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018050001",
            "telephone_number": "781-744-8452",
            "fax_number": "781-744-3440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "LAHEY CLINIC",
            "address_2": "41 MALL RD.",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018050001",
            "telephone_number": "781-744-8452",
            "fax_number": "781-744-3440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZAK",
        "first_name": "ALEXA",
        "middle_name": "T",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-03",
        "last_updated": "2013-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MA",
            "license": "822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "822",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.