Individual provider Active NPI

Mary Margaret Rennick, AU.D.

  • Audiologist
  • Philadelphia, PA
National Provider Identifier
1841928231
Registry record updated Aug 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
Practice address
8100 Roosevelt Blvd Ste 103
Philadelphia, PA 19152-2900
Phone
(215) 535-5598
Fax
(215) 331-4208
NPI assigned
Aug 12, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X Primary

Addresses

Primary practice location

8100 Roosevelt Blvd Ste 103
Philadelphia, PA 19152-2900

Mailing address

8100 Roosevelt Blvd Ste 103
Philadelphia, PA 19152-2900
Phone (215) 535-5598

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251022001030 NJ Practitioner - Qualified Audiologist 4183112188 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2501 Cottontail LN
Somerset, NJ 08873-5125

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Audiology Services Company USA, LLC CurrentSince Aug 9, 2025 Accepting new patients
Audiology Services Company USA, LLC Audiologist Current Accepting new patients
Audiology Services Company USA, LLC CurrentSince Aug 9, 2025 Accepting new patients

Locations

138 Village Center Dr
Unit B4
Freehold, NJ 07728
Phone (732) 683-1140

775 Route 70 E
Ste F120B
Marlton, NJ 08053
Phone (856) 797-1414

2501 Cottontail Ln
Somerset, NJ 08873
Phone (732) 529-7120

8100 Roosevelt Blvd
Ste 103
Philadelphia, PA 19152
Phone (215) 535-1314

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1660262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660262400000",
    "number": "1841928231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8100 ROOSEVELT BLVD STE 103",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191522900",
            "telephone_number": "215-535-5598",
            "fax_number": "215-331-4208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8100 ROOSEVELT BLVD STE 103",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191522900",
            "telephone_number": "215-535-5598",
            "fax_number": "215-331-4208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENNICK",
        "first_name": "MARY",
        "middle_name": "MARGARET",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-12",
        "last_updated": "2022-08-12",
        "certification_date": "2022-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2022; 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.