Individual provider Active NPI

Joella Bova-Larham, AU.D

  • Audiologist
  • Manlius, NY
National Provider Identifier
1972832996
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
57002276 Issued in NY
Practice address
240 W Seneca St Ste 8
Manlius, NY 13104-2539
Phone
(315) 329-6055
NPI assigned
Dec 22, 2009
Sex
Female
Sole proprietor
Yes

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.

Medicare participation

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

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20121211000046 NY Practitioner - Qualified Audiologist 2062664428 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
57002276NYMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Audiology Services Company USA, LLC Audiologist Current Accepting new patients
Audiology Services Company USA, LLC CurrentSince Dec 13, 2017 Accepting new patients
Audiology Services Company USA, LLC CurrentSince Dec 13, 2017 Accepting new patients

Locations

2501 Cottontail Ln
Somerset, NJ 08873
Phone (732) 529-7120

240 W Seneca St
Ste 3
Manlius, NY 13104
Phone (315) 682-2025

106 W Utica St
Ste B
Oswego, NY 13126
Phone (315) 341-5873

1001 James St
Syracuse, NY 13203
Phone (315) 428-0016

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 57002276 NY Primary

Addresses

NPPES NPI Registry

Primary practice location

240 W Seneca St Ste 8
Manlius, NY 13104-2539

Mailing address

240 W Seneca St Ste 8
Manlius, NY 13104-2539
Phone (315) 329-6055

Other names 1

NPPES NPI Registry
  • Joella Bova Former name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 26, 2024.

{
    "created_epoch": "1261440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1972832996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 W SENECA ST STE 8",
            "city": "MANLIUS",
            "state": "NY",
            "postal_code": "131042539",
            "telephone_number": "315-329-6055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 W SENECA ST STE 8",
            "city": "MANLIUS",
            "state": "NY",
            "postal_code": "131042539",
            "telephone_number": "315-329-6055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOVA-LARHAM",
        "first_name": "JOELLA",
        "credential": "AU.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-12-22",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NY",
            "license": "57002276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOELLA",
            "last_name": "BOVA",
            "credential": "AU.D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Manlius, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2024; 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.