Individual provider Active NPI

Kristina Roberts, AUD

  • Audiologist
  • Brockton, MA
National Provider Identifier
1922189737
Registry record updated May 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
567 Issued in MA
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

Updated by the provider on May 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
448791OtherMATUFTS-INDIVIDUAL
626538OtherMAHPHC AUDIOLOGY
AG0032OtherMABCBS AUDIOLOGY GROUP
620733OtherMATUFTS GROUP
AD0194OtherMABCBS AUDIOLOGIST

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061202000128 MA Practitioner - Qualified Audiologist 5496705535 Reassigns benefits to 2 organizations

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
ENT Specialists, IncGroup PAC ID 0648353888, 20 clinicians

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

LicenseStateTypeSpecialty
567MAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
ENT Norwood LLC CurrentSince Feb 1, 2025 Accepting new patients
ENT Specialists, Inc CurrentSince Jan 4, 2021 Accepting new patients
Eleanor Slater Hospital Past Accepting new patients
State of Rhode Island and Providence Plantations PastSince Oct 8, 2009 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

  • FHIR API: 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.

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.

Verify at the official NPI Registry.