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is a Audiologist-hearing Aid Fitter based in Ellisville, Missouri. is licensed to practice in Missouri (license number 536) and their current practice location is 15991 Manchester Rd, Ellisville, Missouri. It can be reached at their office (for appointments etc.) via phone at (636) 394-4240.

NPI number for is 1053458612 and their current mailing address is 15991 Manchester Rd, Ellisville, Missouri. does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1053458612.

Contact Information

15991 Manchester Rd,
Ellisville, MO 63011-2140
(636) 394-4240
Not Available

Map and Direction




Healthcare Provider's Profile

Full Name
TypeFacility
SpecialityAudiologist-hearing Aid Fitter
Location15991 Manchester Rd, Ellisville, Missouri
Accepts Medicare AssignmentsDoes not participate in Medicare Program. The facility may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1053458612
  • Provider Enumeration Date: 01/31/2007
  • Last Update Date: 06/04/2010

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1053458612NPI-NPPES
337894109MedicaidMO

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
231H00000XAudiologist 536 (Missouri)Secondary
231HA2400XAudiologist - Assistive Technology Practitioner 536 (Missouri)Secondary
231HA2500XAudiologist - Assistive Technology Supplier 536 (Missouri)Secondary
235Z00000XSpeech-language Pathologist 536 (Missouri)Secondary
237600000XAudiologist-hearing Aid Fitter 536 (Missouri)Primary
237700000XHearing Instrument Specialist 624 (Missouri)Secondary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address

15991 Manchester Rd,
Ellisville, MO 63011-2140

Ph: (636) 394-4240
15991 Manchester Rd,
Ellisville, MO 63011-2140

Ph: (636) 394-4240

Reviews and Comments



Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.