Individual provider Active NPI

Lois Mary Bennardo, M.S. CCC-A

  • Audiologist
  • Huntington, NY
National Provider Identifier
1689943029
Registry record updated Feb 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
797-1 Issued in NY
Practice address
325 Park Ave
Huntington, NY 11743-2779
Phone
(631) 351-3722
NPI assigned
Dec 14, 2011
Last updated
Feb 29, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 797-1 NY Primary

Addresses

Primary practice location

325 Park Ave
Huntington, NY 11743-2779

Mailing address

128 Vanderbilt Ave
Manhasset, NY 11030-1964
Phone (516) 570-6181

Other names 1

  • Miss Lois Mary Genova Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120228000166 NY Practitioner - Qualified Audiologist 0840458451 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
000797NYMDRegistered Dietitian
797-1NYMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Audiology Distribution, LLC CurrentSince May 1, 2019 Accepting new patients

Locations

800 Northern Blvd
Great Neck, NY 11021
Phone (516) 829-8450

1776 Broadway
New York, NY 10019
Phone (212) 399-7329

Organizations & group practices 1

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": "1323820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330473600000",
    "number": "1689943029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 VANDERBILT AVE",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110301964",
            "telephone_number": "516-570-6181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 PARK AVE",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117432779",
            "telephone_number": "631-351-3722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNARDO",
        "first_name": "LOIS",
        "middle_name": "MARY",
        "name_prefix": "Mrs.",
        "credential": "M.S. CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-14",
        "last_updated": "2012-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NY",
            "license": "797-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LOIS",
            "last_name": "GENOVA",
            "middle_name": "MARY",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Huntington, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2012; 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.