Individual provider Active NPI

Kaitlyn League, AUD

  • Audiologist
  • Tyler, TX
National Provider Identifier
1902537533
Registry record updated Jun 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
81346 Issued in TX
Practice address
1136 E Grande Blvd
Tyler, TX 75703-3982
Phone
(903) 592-5601
NPI assigned
Jun 23, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 81346 TX Primary

Addresses

Primary practice location

1136 E Grande Blvd
Tyler, TX 75703-3982

Mailing address

1136 E Grande Blvd
Tyler, TX 75703-3982

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220707003061 TX Practitioner - Qualified Audiologist 7618357666 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.86 of 100Reported as group
Quality
90.06
Promoting interoperability
98
Improvement activities
40
Cost
61.15

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Heaton Ear Nose and Throat Associates of East Texas P a CurrentSince Jun 21, 2022 Accepting new patients

Locations

1136 E Grande Blvd
Tyler, TX 75703
Phone (903) 592-3666

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": "1655942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1902537533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1136 E GRANDE BLVD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757033982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1136 E GRANDE BLVD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757033982",
            "telephone_number": "903-592-5601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEAGUE",
        "first_name": "KAITLYN",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-23",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "TX",
            "license": "81346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2022; 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.