Organization Active NPI

Tesoriero Chiropractic Office, PC

  • Health Service Clinic/Center
  • Oswego, NY
National Provider Identifier
1003107954
Registry record updated Sep 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
X002605-1 Issued in NY
Legal business name
TESORIERO CHIROPRACTIC OFFICE, PC
Practice address
208 Syracuse Ave
Oswego, NY 13126-3122
Phone
(315) 343-5713
Fax
(315) 343-5714
NPI assigned
Apr 27, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2011

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

Authorized official

Name
Dr. Richard John Tesoriero, DCNPI 1174615603
Title
Owner/Provider
Phone
(315) 343-5713

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X X002605-1 NY Primary

Addresses

Primary practice location

208 Syracuse Ave
Oswego, NY 13126-3122

Mailing address

208 Syracuse Ave
Oswego, NY 13126-3122
Phone (315) 343-5713

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110416000020 NY Part B Supplier - Clinic/Group Practice 3274717269 Receives reassigned benefits from 1 practitioner
Practice locations: Oswego, NY

National Provider Directory

National Provider Directory

Locations

208 Syracuse Ave
Oswego, NY 13126
Phone (315) 343-5713

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1303862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316044800000",
    "number": "1003107954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 SYRACUSE AVE",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131263122",
            "telephone_number": "315-343-5713",
            "fax_number": "315-343-5714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 SYRACUSE AVE",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131263122",
            "telephone_number": "315-343-5713",
            "fax_number": "315-343-5714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TESORIERO CHIROPRACTIC OFFICE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-27",
        "last_updated": "2011-09-15",
        "status": "A",
        "authorized_official_last_name": "TESORIERO",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "315-343-5713",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NY",
            "license": "X002605-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oswego, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2011; 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.