Individual provider Active NPI

Cynthia Ann Modrosic, MA, MS

  • Audiologist
  • Union, MO
National Provider Identifier
1801068077
Registry record updated Jun 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
2002021117 Issued in MO
Practice address
427 Jane Ave
Union, MO 63084-1907
Phone
(636) 583-4902
Fax
(636) 583-4925
NPI assigned
Mar 28, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 2002021117 MO Primary

Addresses

Primary practice location

427 Jane Ave
Union, MO 63084-1907

Mailing address

427 Jane Ave
Union, MO 63084-1907
Phone (636) 583-4902

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080922000126 MO Practitioner - Qualified Audiologist 6305913146 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

427 Jane Ave
Union, MO 63084-1907
Phone (636) 583-4902

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts, Master of Science

State licenses

LicenseStateTypeSpecialty
2002021117MOMDAudiologist

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": "1206662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433376000000",
    "number": "1801068077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "427 JANE AVE",
            "city": "UNION",
            "state": "MO",
            "postal_code": "630841907",
            "telephone_number": "636-583-4902",
            "fax_number": "636-583-4925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "427 JANE AVE",
            "city": "UNION",
            "state": "MO",
            "postal_code": "630841907",
            "telephone_number": "636-583-4902",
            "fax_number": "636-583-4925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODROSIC",
        "first_name": "CYNTHIA",
        "middle_name": "ANN",
        "credential": "MA, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-28",
        "last_updated": "2015-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MO",
            "license": "2002021117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Union, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2015; 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.