Judith Ann Demorest, AUD
Individual provider Active NPI Audiologist-Hearing Aid Fitter · Saint Paul, MN
NPI 1720252018 · NPPES record last updated Feb 8, 2018
Key facts
- NPI
- 1720252018
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Audiologist-Hearing Aid Fitter 237600000X
- License
- 9818 (MN)
- Practice address
- 393 Dunlap St N Ste 115
Saint Paul, MN 55104-4203 - Phone
- (651) 649-3018
- NPI assigned
- Apr 17, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Qualified Audiologist
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Audserv Inc
Practice addresses (Care Compare)
7745 2ND Ave S
Richfield, MN 55423-4576
Phone (612) 824-8689
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TX, MN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20081023000838 | TX | Practitioner - Qualified Audiologist | 7517025273 | |
| I20170926002748 | MN | Practitioner - Qualified Audiologist | 7517025273 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 50636 | TX | MD | Hearing Instrument Specialist |
| 9818 | MN | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Audserv Inc. | Current |
Accepting new patients | |
| University of Texas at Dallas | Audiologist-Hearing Aid Fitter | Past |
Accepting new patients |
Locations
7800 Market Blvd
Chanhassen, MN 55317
Phone (952) 934-4500
7745 2nd Ave S
Richfield, MN 55423
Phone (612) 824-8689
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist-Hearing Aid Fitter | 237600000X | 9818 | MN | Yes |
Addresses
Primary practice location
393 Dunlap St N Ste 115
Saint Paul, MN 55104-4203
Mailing address
393 Dunlap St N Ste 115
Saint Paul, MN 55104-4203
Phone (651) 649-3018
Other providers in Saint Paul, MN
- Delta Care Network Inc
- Caleb Delvaux
- Alistair Ross Demcoe
- Kurt C Demel
- Rachel M Demlow
- Justin James Dempsey
- Rebecca Deneui
- Nybol Deng
- Molly Katherine Dennert
- Nolan Andrew Denny
All providers in Saint Paul, MN · Audiologist-Hearing Aid Fitter in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 8, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.