Active NPI
Mindy Lee Duboff, MA AUDIOLOGY
- Audiologist
- Forest Hills, NY
National Provider Identifier
1811099187
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 511
- Practice address
- 10721 Queens Blvd
Forest Hills, NY 11375 - Phone
- (718) 520-1594
- Fax
- (718) 520-8610
- NPI assigned
- Sep 5, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 511 | NY | Primary |
Addresses
Primary practice location
10721 Queens Blvd
Forest Hills, NY 11375
Mailing address
15 Suydam Drive
Melville, NY 11747
Phone (631) 673-3296
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090415000236 | NY | Practitioner - Qualified Audiologist | 4183771843 | Practice locations: Forest Hills, NY |
Care Compare profile
Medicare Care Compare- Specialty
- Qualified Audiologist
- Education
- Other, 1977
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
10721 Queens Blvd
Forest Hills, NY 11375-4413
Phone (718) 520-1594
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000511 | NY | MD | Art Therapist |
| 511 | NY | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1811099187",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 SUYDAM DRIVE",
"city": "MELVILLE",
"state": "NY",
"postal_code": "11747",
"telephone_number": "631-673-3296",
"fax_number": "631-673-0518"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10721 QUEENS BLVD",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "11375",
"telephone_number": "718-520-1594",
"fax_number": "718-520-8610"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUBOFF",
"first_name": "MINDY",
"middle_name": "LEE",
"credential": "MA AUDIOLOGY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "NY",
"license": "511",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Forest Hills, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.