NPIMap

Organization Active NPI

Mobile Audiology Associates, P.C.

Doing business as HealthDrive Audiology Group

  • Audiologist
  • Brookfield, WI
National Provider Identifier
1811928062
Registry record updated Jan 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
Legal business name
MOBILE AUDIOLOGY ASSOCIATES, P.C.
Doing business as
HealthDrive Audiology Group
Practice address
200 S Executive Dr
Suite 101
Brookfield, WI 53005-4216
Phone
(414) 535-8134
Fax
(414) 535-8135
NPI assigned
Jul 5, 2006
Last updated
Jan 2, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2020

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

Authorized official

Name
Dr. Laura L. Tasse, AUDNPI 1063456481
Title
Owner/President
Phone
(617) 964-6681

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X NU Primary

Addresses

Primary practice location

200 S Executive Dr
Suite 101
Brookfield, WI 53005-4216

Mailing address

100 Crossing Blvd
Suite 300
Framingham, MA 01702-5555
Phone (617) 964-6681

Other identifiers 2

IdentifierTypeStateIssuer
41173200MedicaidWI
CI6118OtherWIMEDICARE RAILROAD

Other names 1

  • HealthDrive Audiology Group Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040907000700 WI Part B Supplier - Clinic/Group Practice 3678465283 Receives reassigned benefits from 3 practitioners
Practice locations: Menomonie, WI; Milwaukee, WI; Muskego, WI; New Berlin, WI; Omro, WI; Oshkosh, WI; Peshtigo, WI; Plymouth, WI…

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Mobile Audiology Associates8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Ownership & related parties

All facility ownership & control disclosures 18

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Carmel Health & Living CommunityCarmel, IN, CCN 155181 Skilled nursing facility Adp of the SNF Mar 7, 2019
Countryside Manor Health & Living CommunityAnderson, IN, CCN 155258 Skilled nursing facility Adp of the SNF Mar 7, 2019
Rawlins House Health & Living CommunityPendleton, IN, CCN 155357 Skilled nursing facility Adp of the SNF Mar 7, 2019
Harbour Manor Health & Living CommunityNoblesville, IN, CCN 155381 Skilled nursing facility Adp of the SNF Mar 7, 2019
Brown County Health & Living CommunityNashville, IN, CCN 155487 Skilled nursing facility Adp of the SNF Mar 7, 2019
Paoli Health & Living CommunityPaoli, IN, CCN 155333 Skilled nursing facility Adp of the SNF Mar 7, 2019
Arbor Trace Health & Living CommunityRichmond, IN, CCN 155481 Skilled nursing facility Adp of the SNF Mar 7, 2019
Altenheim Health & Living CommunityIndianapolis, IN, CCN 155196 Skilled nursing facility Adp of the SNF Mar 7, 2019
Morristown ManorMorristown, IN, CCN 155691 Skilled nursing facility Adp of the SNF Mar 7, 2019
Brookside Village, IncJasper, IN, CCN 155703 Skilled nursing facility Adp of the SNF Mar 7, 2019
Hamilton Trace of FishersFishers, IN, CCN 155793 Skilled nursing facility Adp of the SNF Mar 7, 2019
Aspen Trace Health & Living CommunityGreenwood, IN, CCN 155821 Skilled nursing facility Adp of the SNF Mar 7, 2019
Cumberland Trace Health & Living CommunityPlainfield, IN, CCN 155836 Skilled nursing facility Adp of the SNF Mar 7, 2019
University Heights Health and Living CommunityIndianapolis, IN, CCN 155327 Skilled nursing facility Adp of the SNF Mar 7, 2019
Copper Trace Health & Living CommunityWestfield, IN, CCN 155841 Skilled nursing facility Adp of the SNF Mar 7, 2019
Greenwood Health and Living CommunityGreenwood, IN, CCN 155412 Skilled nursing facility Adp of the SNF Mar 7, 2019
Bell Trace Health and Living CenterBloomington, IN, CCN 155677 Skilled nursing facility Adp of the SNF Mar 7, 2019
Lincoln Hills of New AlbanyNew Albany, IN, CCN 155614 Skilled nursing facility Adp of the SNF Mar 7, 2019

Owned or controlled facilities with NPI records 19

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 19

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577923200000",
    "number": "1811928062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CROSSING BLVD",
            "address_2": "SUITE 300",
            "city": "FRAMINGHAM",
            "state": "MA",
            "postal_code": "017025555",
            "telephone_number": "617-964-6681",
            "fax_number": "339-686-2561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S EXECUTIVE DR",
            "address_2": "SUITE 101",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530054216",
            "telephone_number": "414-535-8134",
            "fax_number": "414-535-8135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE AUDIOLOGY ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2020-01-02",
        "certification_date": "2020-01-02",
        "status": "A",
        "authorized_official_last_name": "TASSE",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "617-964-6681",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "AUD"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41173200",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CI6118",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HealthDrive Audiology Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "HealthDrive Audiology Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brookfield, WI

Sources for this page

Verify at the official NPI Registry.