Individual provider Active NPI

Elizabeth Pancoast, AUD

  • Audiologist
  • Boulder, CO
National Provider Identifier
1699398412
Registry record updated May 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
Practice address
409 Ucb 2501 Kittredge Loop Drive
Boulder, CO 80309-0001
Phone
(303) 492-3404
NPI assigned
May 27, 2020
Last updated
May 27, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X Primary

Addresses

Primary practice location

409 Ucb 2501 Kittredge Loop Drive
Boulder, CO 80309-0001

Mailing address

924 Clover Cir
Lafayette, CO 80026-1774
Phone (303) 514-9202

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200824001667 CO Practitioner - Qualified Audiologist 3577980473 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Hearing Services, Inc. Audiologist CurrentSince Aug 19, 2020 Accepting new patients
Denver Health and Hospital Authority CurrentSince Jul 2, 2023 Accepting new patients
Denver Health and Hospital Authority CurrentSince Jul 2, 2023 Accepting new patients
Professional Hearing Services Corp. Audiologist PastSince Aug 19, 2020 Accepting new patients

Locations

777 Bannock St
Denver, CO 80204

2405 Wadsworth Blvd
Lakewood, CO 80214
Phone (303) 237-4967

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.

NPI Registry JSON

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

{
    "created_epoch": "1590537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590537600000",
    "number": "1699398412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "924 CLOVER CIR",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800261774",
            "telephone_number": "303-514-9202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 UCB 2501 KITTREDGE LOOP DRIVE",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803090001",
            "telephone_number": "303-492-3404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANCOAST",
        "first_name": "ELIZABETH",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-27",
        "last_updated": "2020-05-27",
        "certification_date": "2020-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2020; 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.