Individual provider Active NPI

Jill Bambaci, AU.D

  • Audiologist
  • Somerville, NJ
National Provider Identifier
1770163404
Registry record updated Apr 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
41YA00066000 Issued in NJ
Practice address
110 Rehill Ave
Somerville, NJ 08876-2519
Phone
(908) 685-2549
Fax
(908) 243-8664
NPI assigned
Apr 8, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid Fitter 237600000X 25MG00103900 NJ
Audiologist 231H00000X 41YA00066000 NJ Primary

Addresses

Primary practice location

110 Rehill Ave
Somerville, NJ 08876-2519

Mailing address

110 Rehill Ave
Somerville, NJ 08876-2519
Phone (908) 685-2549

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
41YA00066000NJMDAudiologist
25MG00103900NJMDAudiologist-Hearing Aid Fitter

NPI Registry JSON

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

{
    "created_epoch": "1617840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617840000000",
    "number": "1770163404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 REHILL AVE",
            "city": "SOMERVILLE",
            "state": "NJ",
            "postal_code": "088762519",
            "telephone_number": "908-685-2549",
            "fax_number": "908-243-8664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 REHILL AVE",
            "city": "SOMERVILLE",
            "state": "NJ",
            "postal_code": "088762519",
            "telephone_number": "908-685-2549",
            "fax_number": "908-243-8664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAMBACI",
        "first_name": "JILL",
        "credential": "AU.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-08",
        "last_updated": "2021-04-08",
        "certification_date": "2021-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "NJ",
            "license": "25MG00103900",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NJ",
            "license": "41YA00066000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerville, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2021; 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.