DR. NICOLE ZANDER RAVEN (AUD) – Audiologist-Hearing Aid Fitter, NPI 1790922797

DR. NICOLE ZANDER RAVEN (AUD) is a healthcare provider. based in Philadelphia, Pennsylvania. specializing in QUALIFIED AUDIOLOGIST. They hold the professional credentials AUD. They hold a License No. 41YA00096400 (NJ). The NPI Number for DR. NICOLE ZANDER RAVEN (AUD) is 1790922797

Main info

Female
13 Years Of Experience
Accepts Medicare Assignment
Name
DR. NICOLE ZANDER RAVEN (AUD)
NPI
1790922797
Phone
(215) 629-1353
Address
1843 S Broad St
Enumeration Date
13 January 2009
Last Update Date
20 February 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8176413750
Graduation Year
2013 (13 years ago)
PAC ID
1557419835
Group Practice PAC ID
9739253741
Professional Enrollment ID
I20240402003682
Address ID
TX760334654CL1317XDRXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness75
Years active:17State licenses:1Digital endpointsOther names

478 QUALIFIED AUDIOLOGIST in PA

Provider Addresses for DR. NICOLE ZANDER RAVEN (AUD)

  • 1843 S Broad St

    Philadelphia, PA 191482115

    Phone: (215) 629-1353

    Fax: (215) 629-1395

    Type: Location

  • South Broad Street, Packer Park, South Philadelphia, Philadelphia, Philadelphia County, Pennsylvania, 19145, United States

    PHILADELPHIA, PA 191482115

    Phone: (215) 629-1353

    Fax: (215) 629-1395

    Type: Mailing

  • 6 SAND HILL RD STE 302

    FLEMINGTON, NJ 08822

    Phone: (908) 788-9131

    Fax: (908) 788-0945

    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: 2024-04-02

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240402003682IQualified AudiologistTXTBD

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.

Verify on CMS Revalidation Lookup Tool

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 19148)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9739253741View full group profile
NameSpecialtyState
O T O L A R Y N G O L O G YTX

Reviews

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Frequently asked questions

Where can patients find DR. NICOLE ZANDER RAVEN (AUD)'s NPI?
You can confirm DR. NICOLE ZANDER RAVEN (AUD) with NPI 1790922797; it appears in the national provider directory.
Does this profile mean DR. NICOLE ZANDER RAVEN (AUD) is currently active?
Yes — DR. NICOLE ZANDER RAVEN (AUD) appears active in the national provider directory.
What does DR. NICOLE ZANDER RAVEN (AUD) treat or focus on?
Patients typically see DR. NICOLE ZANDER RAVEN (AUD) under the specialty Audiologist-Hearing Aid Fitter. Clinical services aligned with this taxonomy classification.
What location shows for DR. NICOLE ZANDER RAVEN (AUD)?
We surface Philadelphia, Pennsylvania for DR. NICOLE ZANDER RAVEN (AUD) based on available NPPES addresses.
Is DR. NICOLE ZANDER RAVEN (AUD) a real provider?
This page reflects official NPPES data for NPI 1790922797. Always confirm identity and privileges with the practice and licensing boards.

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