Individual provider Active NPI

Phyllip Taylor-Alonso, AU.D.

  • Audiologist
  • Des Peres, MO
National Provider Identifier
1992176754
Registry record updated Mar 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
159 Issued in HI
Practice address
1010 Old Des Peres Rd
Des Peres, MO 63131-1865
Phone
(314) 729-0077
NPI assigned
Oct 19, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 159 HI Primary

Addresses

Primary practice location

1010 Old Des Peres Rd
Des Peres, MO 63131-1865

Mailing address

1010 Old Des Peres Rd
Des Peres, MO 63131-1865
Phone (314) 729-0077

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200113002638 MO Practitioner - Qualified Audiologist 7214292770 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest ENT Centre, PCGroup PAC ID 5597839878, 12 clinicians

Practice addresses (Care Compare)

4790 Executive Centre Pkwy
Saint Peters, MO 63376-1606
Phone (636) 441-3100

Merit-based Incentive Payment System (MIPS)

Final score
92.44 of 100Reported as group
Quality
100
Improvement activities
40
Cost
74.79

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
159HIMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest ENT Centre, PC CurrentSince Oct 3, 2022 Accepting new patients

Locations

4790 Executive Centre Pkwy
Saint Peters, MO 63376
Phone (636) 441-3100

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": "1445212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616457600000",
    "number": "1992176754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 OLD DES PERES RD",
            "city": "DES PERES",
            "state": "MO",
            "postal_code": "631311865",
            "telephone_number": "314-729-0077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 OLD DES PERES RD",
            "city": "DES PERES",
            "state": "MO",
            "postal_code": "631311865",
            "telephone_number": "314-729-0077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR-ALONSO",
        "first_name": "PHYLLIP",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-19",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "HI",
            "license": "159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Peres, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; 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.