Active NPI
Kristina Roberts, AUD
- Audiologist
- Brockton, MA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 567
- Practice address
- 35 Pearl St Ste 200
Brockton, MA 02301-2866 - Phone
- (508) 588-8034
- Fax
- (508) 897-0475
- NPI assigned
- Oct 18, 2006
- Sex
- Female
- Sole proprietor
- No
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 | 567 | MA | Primary |
Addresses
Primary practice location
35 Pearl St Ste 200
Brockton, MA 02301-2866
Mailing address
35 Pearl St Ste 100
Brockton, MA 02301-2866
Phone (781) 769-3222
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 448791 | Other | MA | TUFTS-INDIVIDUAL |
| 626538 | Other | MA | HPHC AUDIOLOGY |
| AG0032 | Other | MA | BCBS AUDIOLOGY GROUP |
| 620733 | Other | MA | TUFTS GROUP |
| AD0194 | Other | MA | BCBS AUDIOLOGIST |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Qualified Audiologist
- Education
- Other, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
35 Pearl St
Suite 200
Brockton, MA 02301-2866
Phone (508) 588-8034
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 567 | MA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| ENT Norwood LLC | Current | Accepting new patients | |
| ENT Specialists, Inc | Current | Accepting new patients | |
| Eleanor Slater Hospital | Past | Accepting new patients | |
| State of Rhode Island and Providence Plantations | Past | Accepting new patients |
Locations
35 Pearl St
Ste 200
Brockton, MA 02301
Phone (508) 588-8034
35 Pearl St
Ste 100
Brockton, MA 02301
Phone (508) 588-8034
825 Washington St
Ste 310
Norwood, MA 02062
Phone (508) 880-3460
188 Washington St
Plainville, MA 02762
Phone (508) 699-1701
72 Washington St
Ste 1600
Taunton, MA 02780
Phone (508) 880-3460
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/HFADAA
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.
-
- Otolaryngology Physician
- Brockton, MA
- NPI 1548319809
-
- Otolaryngology Physician
- Norwood, MA
- NPI 1265749907
-
- Long Term Care Hospital
- Cranston, RI
- NPI 1922197789
-
- Speech-Language Pathologist
- Kingston, RI
- NPI 1497850499
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161129600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620172800000",
"number": "1922189737",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35 PEARL ST STE 100",
"city": "BROCKTON",
"state": "MA",
"postal_code": "023012866",
"telephone_number": "781-769-3222",
"fax_number": "781-255-9807"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "35 PEARL ST STE 200",
"city": "BROCKTON",
"state": "MA",
"postal_code": "023012866",
"telephone_number": "508-588-8034",
"fax_number": "508-897-0475"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "KRISTINA",
"credential": "AUD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-18",
"last_updated": "2021-05-05",
"certification_date": "2021-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "MA",
"license": "567",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS-INDIVIDUAL",
"identifier": "448791",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HPHC AUDIOLOGY",
"identifier": "626538",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS AUDIOLOGY GROUP",
"identifier": "AG0032",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS GROUP",
"identifier": "620733",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS AUDIOLOGIST",
"identifier": "AD0194",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Brockton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2021; 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.