Individual provider Active NPI

Michelle Booth

  • Audiologist
  • Port Richey, FL
National Provider Identifier
1992580419
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AY2755 Issued in FL
Practice address
11031 US Highway 19
Port Richey, FL 34668-2213
Phone
(201) 961-4094
NPI assigned
Aug 31, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AY2755 FL Primary

Addresses

Primary practice location

11031 US Highway 19
Port Richey, FL 34668-2213

Mailing address

11031 US Highway 19 Ste 104
Port Richey, FL 34668-2213
Phone (727) 247-1234

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231011004113 FL Practitioner - Qualified Audiologist 4385099324 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AY2755FLMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
West Coast Ear, Nose & Throat Inc CurrentSince Oct 12, 2023 Accepting new patients
Audiology Distribution, LLC CurrentSince Mar 28, 2025 Accepting new patients
Hearusa Inc Past Accepting new patients

Locations

1330 S Fort Harrison Ave
Clearwater, FL 33756
Phone (727) 216-0700

30220 US Highway 19 N
Ste 222
Clearwater, FL 33761
Phone (727) 781-1760

646 Virginia St
Fl 3
Dunedin, FL 34698
Phone (727) 441-3588

3251 Hollywood Blvd
Ste 424
Hollywood, FL 33021
Phone (954) 963-6305

800 E Merritt Island Cswy
Ste 104
Merritt Island, FL 32952
Phone (321) 735-4942

11031 US Highway 19
Ste 104
Port Richey, FL 34668
Phone (727) 791-1368

11031 US Highway 19
Port Richey, FL 34668
Phone (201) 961-4094

11304 State Road 54
Trinity, FL 34655
Phone (727) 247-1234

250 Avenue K SW
Ste 105
Winter Haven, FL 33880
Phone (863) 268-2105

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.1528

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1693440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1992580419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11031 US HIGHWAY 19 STE 104",
            "city": "PORT RICHEY",
            "state": "FL",
            "postal_code": "346682213",
            "telephone_number": "727-247-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11031 US HIGHWAY 19",
            "city": "PORT RICHEY",
            "state": "FL",
            "postal_code": "346682213",
            "telephone_number": "201-961-4094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTH",
        "first_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-31",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "FL",
            "license": "AY2755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Richey, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2025; 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.