Active NPI
Anna Ellis, MA, CCC-A
- Audiologist
- Mesa, AZ
National Provider Identifier
1902084767
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- DA4890
- Practice address
- 1237 S Val Vista Dr Ste 111
Mesa, AZ 85204-6401 - Phone
- (480) 807-5410
- Fax
- (480) 396-0532
- NPI assigned
- Feb 4, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | DA4890 | AZ | Primary |
Addresses
Primary practice location
1237 S Val Vista Dr Ste 111
Mesa, AZ 85204-6401
Mailing address
750 N Commons Dr Ste 200
Aurora, IL 60504-7940
Phone (630) 303-5380
Other practice location 1
8300 N Hayden Rd Ste E102
Scottsdale, AZ 85258-2589
Phone (480) 305-2033
Other names 1
- Anna M. Waluk
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DA4890 | AZ | MD | Audiologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Connect Hearing, Inc. | Audiologist | Past | Accepting new patients |
| Connect Hearing, Inc. | Audiologist | Past | Accepting new patients |
Organizations & group practices 2
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": "1202083200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629072000000",
"number": "1902084767",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "750 N COMMONS DR STE 200",
"city": "AURORA",
"state": "IL",
"postal_code": "605047940",
"telephone_number": "630-303-5380",
"fax_number": "630-303-5385"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1237 S VAL VISTA DR STE 111",
"city": "MESA",
"state": "AZ",
"postal_code": "852046401",
"telephone_number": "480-807-5410",
"fax_number": "480-396-0532"
}
],
"practiceLocations": [
{
"address_1": "8300 N Hayden Rd Ste E102",
"address_purpose": "LOCATION",
"city": "Scottsdale",
"state": "AZ",
"postal_code": "852582589",
"country_code": "US",
"telephone_number": "480-305-2033",
"fax_number": "480-305-2034",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ELLIS",
"first_name": "ANNA",
"credential": "MA, CCC-A",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-02-04",
"last_updated": "2021-08-16",
"certification_date": "2021-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "AZ",
"license": "DA4890",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ANNA",
"last_name": "WALUK",
"middle_name": "M.",
"credential": "MA, CCC-A",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.