Individual provider Active NPI

Crystal Marie Sammarco

  • Hearing Instrument Specialist
  • Port Charlotte, FL
National Provider Identifier
1699534610
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Instrument SpecialistTaxonomy code 237700000X
License
AST1300 Issued in FL
Practice address
1900 Tamiami TRL Unit 109
Port Charlotte, FL 33948-2174
Phone
(941) 743-5211
NPI assigned
Mar 14, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Instrument Specialist 237700000X AST1300 FL Primary

Addresses

Primary practice location

1900 Tamiami TRL Unit 109
Port Charlotte, FL 33948-2174

Mailing address

850 Jarvis St
Port Charlotte, FL 33948-3506
Phone (941) 628-9471

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AST1300FLMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Audiology Distribution, LLC CurrentSince Mar 17, 2024 Accepting new patients
Lifestyle Hearing Corporation USA Inc Hearing Instrument Specialist Past Accepting new patients
Hearusa Inc PastSince Mar 17, 2024 Accepting new patients

Locations

4600 Summerlin Rd
Ste C6
Fort Myers, FL 33919
Phone (239) 703-7546

1900 Tamiami Trl
Unit 109
Port Charlotte, FL 33948
Phone (941) 743-5211

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1710374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1699534610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 JARVIS ST",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339483506",
            "telephone_number": "941-628-9471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 TAMIAMI TRL UNIT 109",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339482174",
            "telephone_number": "941-743-5211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMMARCO",
        "first_name": "CRYSTAL",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-14",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "FL",
            "license": "AST1300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.