Individual provider Active NPI

Evelyn Moreau, H.I.S.

  • Hearing Instrument Specialist
  • Rego Park, NY
National Provider Identifier
1790194173
Registry record updated Sep 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Instrument SpecialistTaxonomy code 237700000X
License
14000039626 Issued in NY
Practice address
9732 63Rd Rd
Rego Park, NY 11374-1639
Phone
(718) 205-0664
NPI assigned
Aug 11, 2014
Last updated
Sep 16, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Instrument Specialist 237700000X 14000039626 NY Primary

Addresses

Primary practice location

9732 63Rd Rd
Rego Park, NY 11374-1639

Mailing address

9732 63Rd Rd
Rego Park, NY 11374-1639
Phone (718) 205-0664

Other practice location 1

6613 Woodhaven Blvd
Rego Park, NY 11374-5224
Phone (718) 205-0664

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
14000039626NYMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
A & E Hearing Aid Center Hearing Instrument Specialist Current Accepting new patients

Locations

9732 63rd Rd
Rego Park, NY 11374
Phone (718) 255-1018

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1407715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1790194173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9732 63RD RD",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113741639",
            "telephone_number": "718-205-0664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9732 63RD RD",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113741639",
            "telephone_number": "718-205-0664"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6613 Woodhaven Blvd",
            "address_purpose": "LOCATION",
            "city": "Rego Park",
            "state": "NY",
            "postal_code": "113745224",
            "country_code": "US",
            "telephone_number": "718-205-0664",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOREAU",
        "first_name": "EVELYN",
        "credential": "H.I.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-11",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "NY",
            "license": "14000039626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rego Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2020; 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.