NPIMap

Organization Active NPI

State Hearing and Audiology, PC

  • Audiologist-Hearing Aid Fitter
  • Potsdam, NY
National Provider Identifier
1801236476
Registry record updated Feb 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Audiologist-Hearing Aid FitterTaxonomy code 237600000X
License
002042-1 Issued in NY
Legal business name
STATE HEARING AND AUDIOLOGY, PC
Practice address
6609 State Route 56
Potsdam, NY 13676-3547
Phone
(315) 508-4327
Fax
(315) 262-0300
NPI assigned
Jun 27, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2017

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

Authorized official

Name
Mr. Jon D Suarez, M.S., F/AAANPI 1235218256
Title
Owner/Audiologist
Phone
(315) 508-4327

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid FitterGroup: 193400000X SINGLE SPECIALTY GROUP 237600000X 002042-1 NY Primary
Hearing and Speech Clinic/Center 261QH0700X 002042-1 NY
Hearing Aid Equipment 332S00000X 14000020423 NY

Addresses

Primary practice location

6609 State Route 56
Potsdam, NY 13676-3547

Mailing address

6609 State Route 56
Potsdam, NY 13676-3547
Phone (315) 508-4327

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131106001511 NY Part B Supplier - Clinic/Group Practice 3173758711 Receives reassigned benefits from 3 practitioners
Practice locations: Potsdam, NY; Tupper Lake, NY

National Provider Directory

National Provider Directory
Tax ID family
State Hearing and Audiology PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3982 State Route 11
Malone, NY 12953
Phone (518) 753-3277

6609 State Highway 56
Potsdam, NY 13676
Phone (315) 508-4327

44 Park St
Tupper Lake, NY 12986
Phone (518) 897-6396

113 Main St
Whitesboro, NY 13492
Phone (315) 765-6935

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1372291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487548800000",
    "number": "1801236476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6609 STATE ROUTE 56",
            "city": "POTSDAM",
            "state": "NY",
            "postal_code": "136763547",
            "telephone_number": "315-508-4327",
            "fax_number": "315-262-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6609 STATE ROUTE 56",
            "city": "POTSDAM",
            "state": "NY",
            "postal_code": "136763547",
            "telephone_number": "315-508-4327",
            "fax_number": "315-262-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE HEARING AND AUDIOLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-27",
        "last_updated": "2017-02-20",
        "status": "A",
        "authorized_official_last_name": "SUAREZ",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER/AUDIOLOGIST",
        "authorized_official_telephone_number": "315-508-4327",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.S., F/AAA"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "NY",
            "license": "002042-1",
            "primary": true
        },
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": "NY",
            "license": "002042-1",
            "primary": false
        },
        {
            "code": "332S00000X",
            "taxonomy_group": "",
            "desc": "Hearing Aid Equipment",
            "state": "NY",
            "license": "14000020423",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Potsdam, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.