Individual provider Active NPI

Alexa M Rozycki, AUD

  • Audiologist
  • Elkhart, IN
National Provider Identifier
1881440022
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
Practice address
1753 Fulton St
Elkhart, IN 46514-1927
Phone
(574) 293-9448
Fax
(574) 293-9480
NPI assigned
Apr 29, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

1753 Fulton St
Elkhart, IN 46514-1927

Mailing address

3245 Health Dr Ste 100
Granger, IN 46530-1380
Phone (574) 647-1840

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240731002305 IN Practitioner - Qualified Audiologist 5193262863 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
University of Wisconsin School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beacon Medical Group IncGroup PAC ID 1254243306, 575 clinicians

Practice addresses (Care Compare)

1753 Fulton St
Elkhart, IN 46514-1927
Phone (574) 293-9448

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Medical Group Inc CurrentSince Jul 29, 2024 Accepting new patients
Beacon Medical Group, Inc. CurrentSince Jul 29, 2024 Accepting new patients
Beacon Medical Group, Inc. Current Accepting new patients
Beacon Medical Group, Inc. Past Accepting new patients

Locations

1753 Fulton St
Elkhart, IN 46514
Phone (574) 293-9448

6913 N Main St
Granger, IN 46530
Phone (574) 647-1500

3245 Health Dr
Ste 100
Granger, IN 46530
Phone (574) 647-2129

Organizations & group practices 4

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": "1714348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1881440022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 HEALTH DR STE 100",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465301380",
            "telephone_number": "574-647-1840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1753 FULTON ST",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465141927",
            "telephone_number": "574-293-9448",
            "fax_number": "574-293-9480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROZYCKI",
        "first_name": "ALEXA",
        "middle_name": "M",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-29",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhart, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; 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.