Individual provider Active NPI

Elena L Maresca-Robertson, AU.D.

  • Audiologist
  • Stony Brook, NY
National Provider Identifier
1801004858
Registry record updated May 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
001972-1 Issued in NY
Practice address
207 Hallock Rd
Suite 208
Stony Brook, NY 11790-3033
Phone
(631) 780-4327
Fax
(631) 675-6867
NPI assigned
May 21, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 001972-1 NY Primary

Addresses

Primary practice location

207 Hallock Rd
Suite 208
Stony Brook, NY 11790-3033

Mailing address

207 Hallock Rd
Suite 208
Stony Brook, NY 11790-3033
Phone (631) 780-4327

Other identifiers 1

IdentifierTypeStateIssuer
AA37793OtherNHHARVARD PILGRAM AUDIOLOGY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130830000244 NY Practitioner - Qualified Audiologist 1153357942 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2500 Nesconset Hwy BLDG 3
Suite a
Stony Brook, NY 11790-3073
Phone (631) 780-4327

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001972-1NYMDAudiologist
001972NYMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Hearing and Tinnitus Management Audiology PLLC CurrentSince Jun 22, 2013 Accepting new patients

Locations

2500 Nesconset Hwy
Bldg 3A
Stony Brook, NY 11790
Phone (631) 780-4327

2500 Nesconset Hwy
Ste A
Stony Brook, NY 11790
Phone (631) 780-4327

207 Hallock Rd
Ste 208
Stony Brook, NY 11790
Phone (631) 780-4327

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": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368489600000",
    "number": "1801004858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 HALLOCK RD",
            "address_2": "SUITE 208",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117903033",
            "telephone_number": "631-780-4327",
            "fax_number": "631-675-6867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 HALLOCK RD",
            "address_2": "SUITE 208",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117903033",
            "telephone_number": "631-780-4327",
            "fax_number": "631-675-6867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARESCA-ROBERTSON",
        "first_name": "ELENA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2013-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NY",
            "license": "001972-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRAM AUDIOLOGY",
            "identifier": "AA37793",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2013; 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.