Individual provider Active NPI

Angelica Brielle O'Boyle, AU.D.

  • Audiologist
  • Northridge, CA
National Provider Identifier
1740412741
Registry record updated Sep 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
2988 Issued in CA
Practice address
18433 Roscoe Blvd
Suite 204
Northridge, CA 91325-4108
Phone
(818) 727-7020
Fax
(818) 727-7075
NPI assigned
Aug 10, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X YA767 NJ
Audiologist 231H00000X 2988 CA Primary
Audiologist-Hearing Aid Fitter 237600000X 9115 CA

Addresses

Primary practice location

18433 Roscoe Blvd
Suite 204
Northridge, CA 91325-4108

Mailing address

18433 Roscoe Blvd
Suite 204
Northridge, CA 91325-4108
Phone (818) 727-7020

Other names 1

  • Ms. Angelica Brielle Calandra Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141208000013 CA Practitioner - Qualified Audiologist 5092037820 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

18433 Roscoe Blvd
Suite 204
Northridge, CA 91325-4136
Phone (818) 727-7020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2988CAMDAudiologist
YA767NJMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Hearing Associates, Inc CurrentSince Sep 1, 2014 Accepting new patients

Locations

18433 Roscoe Blvd
Ste 204
Northridge, CA 91325
Phone (818) 727-7020

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1249862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410825600000",
    "number": "1740412741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18433 ROSCOE BLVD",
            "address_2": "SUITE 204",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913254108",
            "telephone_number": "818-727-7020",
            "fax_number": "818-727-7075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18433 ROSCOE BLVD",
            "address_2": "SUITE 204",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913254108",
            "telephone_number": "818-727-7020",
            "fax_number": "818-727-7075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BOYLE",
        "first_name": "ANGELICA",
        "middle_name": "BRIELLE",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-10",
        "last_updated": "2014-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NJ",
            "license": "YA767",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "CA",
            "license": "2988",
            "primary": true
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "CA",
            "license": "9115",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELICA",
            "last_name": "CALANDRA",
            "middle_name": "BRIELLE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Northridge, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2014; 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.