Individual provider Active NPI

Jennifer A Hatzkilson, M.A.

  • Audiologist
  • Irvine, CA
National Provider Identifier
1770513616
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AU1235 Issued in CA
Practice address
62 Corporate Park
Suite 112
Irvine, CA 92606-3122
Phone
(949) 250-9695
Fax
(949) 250-9698
NPI assigned
Jul 4, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AU1235 CA Primary

Addresses

Primary practice location

62 Corporate Park
Suite 112
Irvine, CA 92606-3122

Mailing address

5192 Chablis Cir
Irvine, CA 92604-3168
Phone (949) 250-9695

Other identifiers 3

IdentifierTypeStateIssuer
AU1235OtherCAAUDIOLOGY STATE LICENCE
AU0012350MedicaidCA
HA4149OtherCAHEARING AID DISPENSING

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)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
AU1235CAMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Hearing Amplification Services Inc Audiologist PastSince Aug 13, 2023 Accepting new patients

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": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1770513616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5192 CHABLIS CIR",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926043168",
            "telephone_number": "949-250-9695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 CORPORATE PARK",
            "address_2": "SUITE 112",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926063122",
            "telephone_number": "949-250-9695",
            "fax_number": "949-250-9698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATZKILSON",
        "first_name": "JENNIFER",
        "middle_name": "A",
        "credential": "M.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "CA",
            "license": "AU1235",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AUDIOLOGY STATE LICENCE",
            "identifier": "AU1235",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AU0012350",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEARING AID DISPENSING",
            "identifier": "HA4149",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.