Individual provider Active NPI

Shelley Secoolish Hamilton, AU.D.

  • Audiologist
  • Allenhurst, NJ
National Provider Identifier
1902042914
Registry record updated Mar 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
YA00424 Issued in NJ
Practice address
402 Main St
Allenhurst, NJ 07711-1040
Phone
(732) 517-1200
Fax
(732) 663-0179
NPI assigned
Dec 22, 2008
Last updated
Mar 18, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X YA00424 NJ Primary
Audiologist-Hearing Aid Fitter 237600000X MG00855 NJ

Addresses

Primary practice location

402 Main St
Allenhurst, NJ 07711-1040

Mailing address

223 Monmouth Rd
Ste 1a
West Long Branch, NJ 07764-1024
Phone (732) 229-4089

Other names 1

  • Shelley Dee Secoolish Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050719000733 NJ Practitioner - Qualified Audiologist 0244267581 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
YA00424NJMDAudiologist
MG00855NJMDAudiologist-Hearing Aid Fitter

Practice roles

OrganizationSpecialtyStatusNew patients
A&a Hearing Group, LLC Audiologist CurrentSince Mar 13, 2020 Accepting new patients
A&a Hearing Group, LLC Audiologist-Hearing Aid Fitter CurrentSince Mar 13, 2020 Accepting new patients
American Family Tinnitus Center LLC Audiologist Past Accepting new patients
Mobile Audiology Associates, P.C. Audiologist Past Accepting new patients
Mobile Audiology Associates, P.C. Audiologist Past Accepting new patients
Family Hearing Center Audiologist Past Accepting new patients

Locations

223 Monmouth Rd
Ste 1A
West Long Branch, NJ 07764
Phone (732) 229-4089

Organizations & group practices 6

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": "1229904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584489600000",
    "number": "1902042914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 MONMOUTH RD",
            "address_2": "STE 1A",
            "city": "WEST LONG BRANCH",
            "state": "NJ",
            "postal_code": "077641024",
            "telephone_number": "732-229-4089",
            "fax_number": "732-229-4089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 MAIN ST",
            "city": "ALLENHURST",
            "state": "NJ",
            "postal_code": "077111040",
            "telephone_number": "732-517-1200",
            "fax_number": "732-663-0179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMILTON",
        "first_name": "SHELLEY",
        "middle_name": "SECOOLISH",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-22",
        "last_updated": "2020-03-18",
        "certification_date": "2020-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NJ",
            "license": "YA00424",
            "primary": true
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "NJ",
            "license": "MG00855",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELLEY",
            "last_name": "SECOOLISH",
            "middle_name": "DEE",
            "credential": "MA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Allenhurst, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.