Individual provider Active NPI

Aaron T Gale

  • Audiologist
  • Saint Clair Shores, MI
National Provider Identifier
1689762395
Registry record updated May 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
Practice address
21000 E 12 Mile Rd
Suite 111
Saint Clair Shores, MI 48081-1116
Phone
(586) 779-7610
NPI assigned
Oct 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2008

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X Primary
Assistive Technology Practitioner Audiologist 231HA2400X
Audiologist-Hearing Aid Fitter 237600000X 1601000185 MI

Addresses

Primary practice location

21000 E 12 Mile Rd
Suite 111
Saint Clair Shores, MI 48081-1116

Mailing address

21000 E 12 Mile Rd
Ste 111
St Clair Shores, MI 48081
Phone (586) 779-7610

Other identifiers 5

IdentifierTypeStateIssuer
540E00292OtherMIBLUE SHIELD
P25881FOtherBLUE CARE NETWORK
64EO7684OtherBLUE SHIELD
0E01107OtherMIBLUE SHIELD
904135055MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080908000468 MI Practitioner - Qualified Audiologist 1355417882 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

21000 E 12 Mile Rd
Suite 111
Saint Clair Shores, MI 48081-1156
Phone (586) 779-7610

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1601000185MIMDAudiologist-Hearing Aid Fitter

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health St. John Hospital CurrentSince Feb 1, 2012 Accepting new patients
Henry Ford Health St. John Hospital CurrentSince Feb 1, 2012 Accepting new patients
Henry Ford Health St. John Hospital Current Accepting new patients
Lakeshore Ear Nose and Throat Center PC Past Accepting new patients

Locations

43750 Garfield Rd
Bldg B
Clinton Twp, MI 48038
Phone (248) 620-0044

4150 S River Rd
Ste E
East China, MI 48054
Phone (810) 326-2018

17770 Mack Ave
Grosse Pointe Shores, MI 48230
Phone (313) 882-1731

17900 23 Mile Rd
Ste 203
Macomb, MI 48044
Phone (586) 263-7400

21000 E 12 Mile Rd
Ste 111
St Clr Shores, MI 48081
Phone (586) 779-7610

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211241600000",
    "number": "1689762395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21000 E 12 MILE RD",
            "address_2": "STE 111",
            "city": "ST CLAIR SHORES",
            "state": "MI",
            "postal_code": "48081",
            "telephone_number": "586-779-7610",
            "fax_number": "586-445-2526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21000 E 12 MILE RD",
            "address_2": "SUITE 111",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480811116",
            "telephone_number": "586-779-7610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALE",
        "first_name": "AARON",
        "middle_name": "T",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2008-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "231HA2400X",
            "taxonomy_group": "",
            "desc": "Audiologist, Assistive Technology Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "MI",
            "license": "1601000185",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "540E00292",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK",
            "identifier": "P25881F",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "64EO7684",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "0E01107",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "904135055",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; 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.