Tracey A Irene, AU.D.

Primary specialty

AudiologistTaxonomy code 231H00000X

License

303-156 Issued in WI

Practice address

1111 Delafield St
Suite 102
Waukesha, WI 53188-3417

Phone

(262) 549-5150

Fax

(262) 549-1337

NPI assigned

Feb 1, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Qualified Audiologist

Education

At Still University, Arizona School of Dentistry & Oral HLTH, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Moreland Ear Nose and Throat Group LTDGroup PAC ID 4284605494, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Moreland Ear Nose & Throat Group LTD

  • Specialist
  • Waukesha, WI
  • NPI 1861464182
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207267200000",
    "number": "1699813097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N67W23421 NANCY DR",
            "city": "SUSSEX",
            "state": "WI",
            "postal_code": "530892786",
            "telephone_number": "262-820-0371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 DELAFIELD ST",
            "address_2": "SUITE 102",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531883417",
            "telephone_number": "262-549-5150",
            "fax_number": "262-549-1337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRENE",
        "first_name": "TRACEY",
        "middle_name": "A",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2008-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "WI",
            "license": "303-156",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41135900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Audiologist in Waukesha, WI
• Providers in Waukesha, WI by specialty
• Audiologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 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.