DR. ROGER THEOBALD (AU.D.) – Audiologist, NPI 1417056201
Audiologist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
82 QUALIFIED AUDIOLOGIST in ID
Provider Addresses for DR. ROGER THEOBALD (AU.D.)
1084 N Cole Rd
Boise, ID 837048642
Phone: (208) 377-0019
Fax: (208) 377-0313
Type: Location
Treasure Valley Hearing & Balance, 1084, North Cole Road, Boise Junction, Boise, Ada County, Idaho, 83704, United States
BOISE, ID 837048642
Phone: (208) 377-0019
Fax: (208) 377-0313
Type: Location
1032 S SILVERSTONE WAY STE 160
MERIDIAN, ID 836421080
Phone: (208) 658-0238
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2019-01-09
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20190109002979 | I | Qualified Audiologist | ID | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 83704)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| QUALIFIED AUDIOLOGIST | NV | 92540 | Observation, testing, and recording of abnormal eye movement | 11 | 11 |
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