Individual provider Active NPI

Theresa Trimarco, AU.D.

  • Audiologist
  • Oak Park, IL
National Provider Identifier
1679704639
Registry record updated Jun 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
147001316 Issued in IL
Practice address
610 S Maple Ave
5300
Oak Park, IL 60304-1091
Phone
(708) 660-2350
Fax
(708) 660-2360
NPI assigned
Aug 6, 2009
Last updated
Jun 10, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 147001316 IL Primary

Addresses

Primary practice location

610 S Maple Ave
5300
Oak Park, IL 60304-1091

Mailing address

1550 Sandhurst CT
Unit C
Wheaton, IL 60189-2704

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150216001404 ID Practitioner - Qualified Audiologist 8527107994 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lukes Clinic-Treasure Valley LLCGroup PAC ID 4981878402, 1,155 clinicians

Practice addresses (Care Compare)

510 N 2ND St
Suite 201
Boise, ID 83702-6078
Phone (208) 385-3440

608 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970

610 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
81.29
Promoting interoperability
100
Improvement activities
40
Cost
76.37

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
147001316ILMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Clinic-Treasure Valley LLC CurrentSince Nov 5, 2014 Accepting new patients
Sound Care Hearing Corporation Audiologist Past Accepting new patients
Lester and Rosalie Anixter Center Audiologist PastSince Nov 16, 2009 Accepting new patients
St Lukes Regional Medical Center Past Accepting new patients

Locations

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378

610 W Hays St
Boise, ID 83702
Phone (208) 345-3530

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1249516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307664000000",
    "number": "1679704639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 SANDHURST CT",
            "address_2": "UNIT C",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601892704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 S MAPLE AVE",
            "address_2": "5300",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603041091",
            "telephone_number": "708-660-2350",
            "fax_number": "708-660-2360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIMARCO",
        "first_name": "THERESA",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-06",
        "last_updated": "2011-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IL",
            "license": "147001316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2011; 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.