Individual provider Active NPI

Amanda Marie McInroy, AUD

  • Audiologist
  • Phoenix, AZ
National Provider Identifier
1871015305
Registry record updated Jul 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
DA10692 Issued in AZ
Practice address
4545 E Shea Blvd Ste 174
Phoenix, AZ 85028-3061
Phone
(602) 254-6041
NPI assigned
Jul 17, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X DA10692 AZ Primary

Addresses

Primary practice location

4545 E Shea Blvd Ste 174
Phoenix, AZ 85028-3061

Mailing address

2925 E John Cabot Rd
Phoenix, AZ 85032-1133
Phone (925) 586-4521

Other names 1

  • Amanda Marie Moore Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170911000778 AZ Practitioner - Qualified Audiologist 8224301494 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Affiliated Audiology Consultants, Inc.Group PAC ID 8820260748, 3 clinicians

Practice addresses (Care Compare)

4545 E Shea Blvd
Phoenix, AZ 85028-3061
Phone (602) 254-6041

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DA10692AZMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Affiliated Audiology Consultants, Inc. Audiologist CurrentSince Aug 1, 2017 Accepting new patients

Locations

4545 E Shea Blvd
Ste 174
Phoenix, AZ 85028
Phone (602) 254-6041

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1500249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563408000000",
    "number": "1871015305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 E JOHN CABOT RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850321133",
            "telephone_number": "925-586-4521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 E SHEA BLVD STE 174",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850283061",
            "telephone_number": "602-254-6041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINROY",
        "first_name": "AMANDA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-17",
        "last_updated": "2019-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "AZ",
            "license": "DA10692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "MOORE",
            "middle_name": "MARIE",
            "credential": "AUD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2019; 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.