Individual provider Active NPI

Elyssa Jean Washburn, AU.D.

  • Audiologist
  • Grapevine, TX
National Provider Identifier
1821496696
Registry record updated Mar 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
80854 Issued in TX
Practice address
1042 Texan TRL Ste 200
Grapevine, TX 76051-3703
Phone
(817) 722-6156
Fax
(817) 722-6159
NPI assigned
Dec 10, 2014
Last updated
Mar 5, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 80854 TX Primary

Addresses

Primary practice location

1042 Texan TRL Ste 200
Grapevine, TX 76051-3703

Mailing address

1042 Texan TRL Ste 200
Grapevine, TX 76051-3703
Phone (817) 722-6156

Other practice location 1

1125 S Ball St
Ste 105
Grapevine, TX 76051-4038
Phone (817) 722-6156

Other names 1

  • Ms. Elyssa Jean Doom Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170228001154 TX Practitioner - Qualified Audiologist 0840518270 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washburn Audiology, LLCGroup PAC ID 3274808613, 2 clinicians

Practice addresses (Care Compare)

1042 Texan TRL
Suite 200
Grapevine, TX 76051-3703
Phone (817) 722-6156

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2972CAMDCognitive & Behavioral Psychologist
80854TXMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Washburn Audiology, LLC Audiologist CurrentSince Aug 1, 2017 Accepting new patients

Locations

1025 S Main St
Ste 301
Grapevine, TX 76051
Phone (817) 722-6156

1042 Texan Trl
Ste 200
Grapevine, TX 76051
Phone (817) 722-6156

1111 S Main St
Ste 134
Grapevine, TX 76051
Phone (817) 865-5034

1125 S Ball St
Ste 105
Grapevine, TX 76051
Phone (817) 722-6156

Interoperability endpoints

  • Direct secure messaging: elyssa.doom.p21@direct.monarchhealthcare.nextgenshare.com

Organizations & group practices 1

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": "1418169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772668800000",
    "number": "1821496696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1042 TEXAN TRL STE 200",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760513703",
            "telephone_number": "817-722-6156",
            "fax_number": "817-722-6159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1042 TEXAN TRL STE 200",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760513703",
            "telephone_number": "817-722-6156",
            "fax_number": "817-722-6159"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1125 S BALL ST",
            "address_2": "STE 105",
            "address_purpose": "LOCATION",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760514038",
            "country_code": "US",
            "telephone_number": "817-722-6156",
            "fax_number": "817-722-6159",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WASHBURN",
        "first_name": "ELYSSA",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-10",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "TX",
            "license": "80854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELYSSA",
            "last_name": "DOOM",
            "middle_name": "JEAN",
            "prefix": "MS.",
            "credential": "AU.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grapevine, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2026; 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.