Individual provider Active NPI

Simona Ioffe, AU.D., CCC-A

  • Audiologist
  • Wakefield, MA
National Provider Identifier
1740461326
Registry record updated Aug 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
SP-882-AU Issued in MA
Practice address
306 Main St
Wakefield, MA 01880-5022
Phone
(800) 649-3074
NPI assigned
Nov 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 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 SP-882-AU MA Primary

Addresses

Primary practice location

306 Main St
Wakefield, MA 01880-5022

Mailing address

306 Main St
Wakefield, MA 01880-5022
Phone (800) 649-3074

Other practice location 1

92 High St
Medford, MA 02155-3850
Phone (617) 947-0615

Other identifiers 1

IdentifierTypeStateIssuer
5100291MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, RI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080109000498 MA Practitioner - Qualified Audiologist 5395825830 Reassigns benefits to 2 organizations
I20260521001634 RI Practitioner - Qualified Audiologist 5395825830 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2007
Medicare assignment
May accept Medicare assignment
Group practices
Connecticut Audiology Partners, PLLCGroup PAC ID 3870991128, 2 clinicians
Diagnostic Hearing IncGroup PAC ID 2062746415, 2 clinicians

Practice addresses (Care Compare)

30 Sayles Hill Rd
Manville, RI 02838-1227
Phone (203) 626-5581

92 High St
Suite 23
Medford, MA 02155-3850
Phone (617) 947-0615

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
882MAMDOccupational Therapy Assistant
SP-882-AUMAMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Diagnostic Hearing Inc Audiologist CurrentSince Jul 28, 2020 Accepting new patients
Hearusa Inc PastSince Jan 20, 2017 Accepting new patients

Locations

92 High St
Ste 23
Medford, MA 02155
Phone (617) 947-0615

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1195776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597622400000",
    "number": "1740461326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 MAIN ST",
            "city": "WAKEFIELD",
            "state": "MA",
            "postal_code": "018805022",
            "telephone_number": "800-649-3074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 MAIN ST",
            "city": "WAKEFIELD",
            "state": "MA",
            "postal_code": "018805022",
            "telephone_number": "800-649-3074"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "92 High St",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "MA",
            "postal_code": "021553850",
            "country_code": "US",
            "telephone_number": "617-947-0615",
            "fax_number": "781-723-4691",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IOFFE",
        "first_name": "SIMONA",
        "credential": "AU.D., CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-23",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MA",
            "license": "SP-882-AU",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5100291",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wakefield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2020; 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.