Individual provider Active NPI

Amanda J Moore, M.A CCC-A

  • Audiologist
  • Elgin, IL
National Provider Identifier
1962668616
Registry record updated Jan 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
147.001023 Issued in IL
Practice address
750 Fletcher Dr Ste 100
Elgin, IL 60123-4703
Phone
(847) 741-8500
Fax
(847) 741-8587
NPI assigned
Aug 1, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 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 147.001023 IL Primary

Addresses

Primary practice location

750 Fletcher Dr Ste 100
Elgin, IL 60123-4703

Mailing address

750 Fletcher Dr Ste 100
Elgin, IL 60123-4703
Phone (847) 741-8500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130320000096 IL Practitioner - Qualified Audiologist 6406091578 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fox Valley Ear, Nose and Throat, Assoc., S.C.Group PAC ID 7517858764, 6 clinicians

Practice addresses (Care Compare)

750 Fletcher Dr
Suite 100
Elgin, IL 60123-4703
Phone (847) 741-8500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
147.001023ILMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
The Better Hearing Group, Inc. CurrentSince Jan 3, 2013 Accepting new patients
Fox Valley Ear, Nose and Throat, Assoc., S.C. CurrentSince Jun 1, 2021 Accepting new patients

Locations

2971 W Algonquin Rd
Ste 102
Algonquin, IL 60102
Phone (847) 854-0005

750 Fletcher Dr
Ste 100
Elgin, IL 60123
Phone (847) 741-3677

1555 N Barrington Rd
Ste 303
Hoffman Estates, IL 60169
Phone (847) 781-9368

1730 Park St
Ste 101
Naperville, IL 60563
Phone (630) 718-0200

2210 Dean St
Ste L
St Charles, IL 60175
Phone (630) 377-5000

Organizations & group practices 2

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": "1217548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641859200000",
    "number": "1962668616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 FLETCHER DR STE 100",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601234703",
            "telephone_number": "847-741-8500",
            "fax_number": "847-741-8587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 FLETCHER DR STE 100",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601234703",
            "telephone_number": "847-741-8500",
            "fax_number": "847-741-8587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "AMANDA",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "M.A CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-01",
        "last_updated": "2022-01-11",
        "certification_date": "2022-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IL",
            "license": "147.001023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elgin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 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.