Individual provider Active NPI

Clemente Morales, AUD

  • Audiologist
  • Glendale, AZ
National Provider Identifier
1801409032
Registry record updated Aug 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
DA12580 Issued in AZ
Practice address
5757 W Thunderbird Rd Ste E156
Glendale, AZ 85306-5602
Phone
(602) 978-5187
NPI assigned
Aug 27, 2020
Last updated
Aug 27, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X DA12580 AZ Primary

Addresses

Primary practice location

5757 W Thunderbird Rd Ste E156
Glendale, AZ 85306-5602

Mailing address

2501 Cottontail LN
Somerset, NJ 08873-5125

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200917001015 AZ Practitioner - Qualified Audiologist 6709204126 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Physician Super Specialists Arizona LLC CurrentSince Feb 1, 2023 Accepting new patients
Banner Physician Super Specialists Arizona LLC CurrentSince Feb 1, 2023 Accepting new patients
Banner Physician Super Specialists Arizona LLC Current Accepting new patients

Locations

5310 W Thunderbird Rd
Ste 110
Glendale, AZ 85306
Phone (602) 865-4065

5757 W Thunderbird Rd
Ste E156
Glendale, AZ 85306
Phone (602) 978-5187

1432 S Dobson Rd
Ste 209
Mesa, AZ 85202
Phone (480) 412-6970

1432 S Dobson Rd
Ste 301
Mesa, AZ 85202
Phone (480) 412-7120

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": "1598486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598486400000",
    "number": "1801409032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 COTTONTAIL LN",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088735125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5757 W THUNDERBIRD RD STE E156",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853065602",
            "telephone_number": "602-978-5187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORALES",
        "first_name": "CLEMENTE",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-27",
        "last_updated": "2020-08-27",
        "certification_date": "2020-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "AZ",
            "license": "DA12580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2020; 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.