Individual provider Active NPI

Shayne M Sage, AU.D.

  • Audiologist
  • Surprise, AZ
National Provider Identifier
1679751572
Registry record updated Aug 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
DA1423 Issued in AZ
Practice address
12301 W Bell Rd Ste B104
Surprise, AZ 85378-9706
Phone
(623) 876-0317
Fax
(623) 876-0034
NPI assigned
Feb 4, 2008
Last updated
Aug 18, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X DA1423 AZ Primary
Audiologist-Hearing Aid Fitter 237600000X DA1423 AZ

Addresses

Primary practice location

12301 W Bell Rd Ste B104
Surprise, AZ 85378-9706

Mailing address

750 N Commons Dr Ste 200
Aurora, IL 60504-7940
Phone (630) 303-5380

Other practice location 1

8300 N Hayden Rd Ste E102
Scottsdale, AZ 85258-2589
Phone (480) 305-2033

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140620002230 AZ Practitioner - Qualified Audiologist 8527282177 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Connect Hearing Inc Audiologist CurrentSince Apr 1, 2012 Accepting new patients
Connect Hearing, Inc. Audiologist Past Accepting new patients
Connect Hearing, Inc. Audiologist Past Accepting new patients

Locations

405 N Beaver St
Ste 4
Flagstaff, AZ 86001
Phone (928) 214-0907

1237 S Val Vista Dr
Ste 111
Mesa, AZ 85204
Phone (480) 807-5410

100 Verde Valley School Rd
Ste 105
Sedona, AZ 86351
Phone (928) 284-1289

12301 W Bell Rd
Ste B104
Surprise, AZ 85378
Phone (623) 876-0024

750 N Commons Dr
Ste 200
Aurora, IL 60504

215 Shuman Blvd
Ste 401
Naperville, IL 60563
Phone (331) 229-8279

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

NPI Registry JSON

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

{
    "created_epoch": "1202083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629244800000",
    "number": "1679751572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 N COMMONS DR STE 200",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605047940",
            "telephone_number": "630-303-5380",
            "fax_number": "630-303-5385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12301 W BELL RD STE B104",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853789706",
            "telephone_number": "623-876-0317",
            "fax_number": "623-876-0034"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8300 N Hayden Rd Ste E102",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852582589",
            "country_code": "US",
            "telephone_number": "480-305-2033",
            "fax_number": "480-305-2034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAGE",
        "first_name": "SHAYNE",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-04",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "AZ",
            "license": "DA1423",
            "primary": true
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "AZ",
            "license": "DA1423",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Surprise, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2021; 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.