Individual provider Active NPI

Jordan Baldasare, AU.D.

  • Audiologist
  • Pembroke Pines, FL
National Provider Identifier
1801372644
Registry record updated Jul 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AY2206 Issued in FL
Practice address
12193 Pembroke Rd Ste 313
Pembroke Pines, FL 33025-1727
Phone
(954) 435-8820
NPI assigned
Jul 16, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AY2206 FL Primary

Addresses

Primary practice location

12193 Pembroke Rd Ste 313
Pembroke Pines, FL 33025-1727

Mailing address

3801 W State Road 84 Unit 304
Davie, FL 33312-8813
Phone (757) 813-9182

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190218002851 FL Practitioner - Qualified Audiologist 2567700479 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
ENT and Allergy Associates of Florida, LLCGroup PAC ID 0042292849, 227 clinicians

Practice addresses (Care Compare)

1601 Clint Moore Rd
Suite 135
Boca Raton, FL 33487-5714
Phone (561) 391-3333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
ENT and Allergy Associates of Florida, LLC CurrentSince Jul 11, 2022 Accepting new patients
Hearusa Inc PastSince Mar 22, 2022 Accepting new patients

Locations

6421 Congress Ave
Ste 113
Boca Raton, FL 33487
Phone (561) 338-3267

1601 Clint Moore Rd
Ste 135
Boca Raton, FL 33487
Phone (561) 300-1792

900 NW 13th St
Ste 206
Boca Raton, FL 33486
Phone (561) 338-3267

1601 Clint Moore Rd
Ste 105
Boca Raton, FL 33487
Phone (561) 391-3333

Organizations & group practices 3

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": "1531699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531699200000",
    "number": "1801372644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 W STATE ROAD 84 UNIT 304",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333128813",
            "telephone_number": "757-813-9182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12193 PEMBROKE RD STE 313",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330251727",
            "telephone_number": "954-435-8820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALDASARE",
        "first_name": "JORDAN",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-16",
        "last_updated": "2018-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "FL",
            "license": "AY2206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2018; 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.