Individual provider Active NPI

David L Pellandini, HAD

  • Hearing Instrument Specialist
  • Fort Bragg, CA
National Provider Identifier
1932477460
Registry record updated Sep 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Instrument SpecialistTaxonomy code 237700000X
License
HA2892 Issued in CA
Practice address
103 Cypress St
Fort Bragg, CA 95437-5401
Phone
(707) 962-9230
Fax
(707) 523-0260
NPI assigned
Dec 12, 2011
Last updated
Sep 14, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Instrument Specialist 237700000X HA2892 CA Primary

Addresses

Primary practice location

103 Cypress St
Fort Bragg, CA 95437-5401

Mailing address

103 Cypress St
Fort Bragg, CA 95437-5401
Phone (707) 962-9230

Other identifiers 1

IdentifierTypeStateIssuer
HA2892OtherCAHA DISPENSER LICENSE

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
HA2892CAMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Coast Hearing Aid Center, Inc. CurrentSince Sep 27, 2020 Accepting new patients
New Ear Hearing Aid Center, Inc. Past Accepting new patients

Locations

103 Cypress St
Fort Bragg, CA 95437
Phone (707) 962-9230

Organizations & group practices 3

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": "1323648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600041600000",
    "number": "1932477460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 CYPRESS ST",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "954375401",
            "telephone_number": "707-962-9230",
            "fax_number": "707-962-9230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 CYPRESS ST",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "954375401",
            "telephone_number": "707-962-9230",
            "fax_number": "707-523-0260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLANDINI",
        "first_name": "DAVID",
        "middle_name": "L",
        "credential": "HAD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-12",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "CA",
            "license": "HA2892",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HA DISPENSER LICENSE",
            "identifier": "HA2892",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Bragg, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.