Individual provider Active NPI

Sarah Hall Ellis, AU.D.

  • Audiologist
  • Bronx, NY
National Provider Identifier
1932620465
Registry record updated Jul 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
002715 Issued in NY
Practice address
1225 Morris Park Avenue
Van Etten Building
Bronx, NY 10461
Phone
(703) 577-5010
NPI assigned
Jul 6, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 002715 NY Primary

Addresses

Primary practice location

1225 Morris Park Avenue
Van Etten Building
Bronx, NY 10461

Mailing address

319 E 92ND St Apt 1E
New York, NY 10128-5457

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20191023000044 DC Practitioner - Qualified Audiologist 9537426804 Reassigns benefits to 1 organization
I20240115001794 MD Practitioner - Qualified Audiologist 9537426804 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002715NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kennedy Krieger Associates CurrentSince Dec 6, 2023 Accepting new patients
Kennedy Krieger Associates CurrentSince Dec 6, 2023 Accepting new patients

Locations

707 N Broadway
Baltimore, MD 21205
Phone (443) 923-1870

1741 Ashland Ave
Ste 642
Baltimore, MD 21205

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1499299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500508800000",
    "number": "1932620465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 E 92ND ST APT 1E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101285457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 MORRIS PARK AVENUE",
            "address_2": "VAN ETTEN BUILDING",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10461",
            "telephone_number": "703-577-5010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "SARAH",
        "middle_name": "HALL",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-06",
        "last_updated": "2017-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NY",
            "license": "002715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.