Individual provider Active NPI

Jennifer C Seitz

  • Audiologist
  • Aquebogue, NY
National Provider Identifier
1861409062
Registry record updated Mar 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
002102 Issued in NY
Practice address
292 Shade Tree Lane
Aquebogue, NY 11931
Phone
(631) 727-8050
Fax
(631) 727-8110
NPI assigned
Aug 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 002102 NY Primary

Addresses

Primary practice location

292 Shade Tree Lane
Aquebogue, NY 11931

Mailing address

292 Shade Tree Lane
PO Box 2668
Aquebogue, NY 11931
Phone (631) 727-8050

Other identifiers 2

IdentifierTypeStateIssuer
5750868OtherNYNYS REG CERTIFICATE
002102OtherNYNYS LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060915000018 NY Practitioner - Qualified Audiologist 9638173123 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
ENT and Allergy Associates LLPGroup PAC ID 0749193662, 431 clinicians

Practice addresses (Care Compare)

365 County Rd
39A
Southampton, NY 11968-5284
Phone (631) 283-1142

Merit-based Incentive Payment System (MIPS)

Final score
94.45 of 100Reported as group
Quality
89.91
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts, Master of Science

State licenses

LicenseStateTypeSpecialty
002102NYMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
ENT and Allergy Associates LLP CurrentSince Jul 4, 2011 Accepting new patients
Peconic Ear Nose Throat & Facial Plastic Surgery, PC Past Accepting new patients
ENT and Allergy Associates of Pennsylvania PLLC Past Accepting new patients

Locations

400 Old Country Rd
Ste 16
Riverhead, NY 11901
Phone (631) 574-3419

365 County Road 39A
Southampton, NY 11968
Phone (516) 364-4200

660 White Plains Rd
Fl 4
Tarrytown, NY 10591
Phone (914) 984-2546

1086 N Broadway
Ste 220
Yonkers, NY 10701
Phone (914) 279-9500

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427673600000",
    "number": "1861409062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "292 SHADE TREE LANE",
            "address_2": "PO BOX 2668",
            "city": "AQUEBOGUE",
            "state": "NY",
            "postal_code": "11931",
            "telephone_number": "631-727-8050",
            "fax_number": "631-727-8110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "292 SHADE TREE LANE",
            "city": "AQUEBOGUE",
            "state": "NY",
            "postal_code": "11931",
            "telephone_number": "631-727-8050",
            "fax_number": "631-727-8110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEITZ",
        "first_name": "JENNIFER",
        "middle_name": "C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2015-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NY",
            "license": "002102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS REG CERTIFICATE",
            "identifier": "5750868",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS LICENSE",
            "identifier": "002102",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aquebogue, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2015; 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.