Individual provider Active NPI

Maryna Mykhalova, AUD

  • Audiologist
  • Edison, NJ
National Provider Identifier
1972233013
Registry record updated Jun 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
41YA00119600 Issued in NJ
Practice address
1455 Route 1
Edison, NJ 08837-2418
Phone
(732) 549-7455
NPI assigned
Jun 13, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 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 41YA00119600 NJ Primary

Addresses

Primary practice location

1455 Route 1
Edison, NJ 08837-2418

Mailing address

400 Dutch Neck Rd Apt I2
East Windsor, NJ 08520-1237
Phone (347) 301-1679

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220912001152 NJ Practitioner - Qualified Audiologist 3476938457 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Audiology Distribution, LLC CurrentSince Aug 29, 2022 Accepting new patients

Locations

1455 US Highway 1
Edison, NJ 08837
Phone (732) 549-7455

1455 Route 1
Edison, NJ 08837
Phone (732) 549-7455

66 N Route 17
Paramus, NJ 07652
Phone (201) 291-0550

Organizations & group practices 1

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": "1655078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655078400000",
    "number": "1972233013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 DUTCH NECK RD APT I2",
            "city": "EAST WINDSOR",
            "state": "NJ",
            "postal_code": "085201237",
            "telephone_number": "347-301-1679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 ROUTE 1",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088372418",
            "telephone_number": "732-549-7455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYKHALOVA",
        "first_name": "MARYNA",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-13",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NJ",
            "license": "41YA00119600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edison, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2022; 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.