Individual provider Active NPI

Renee Boccio, DC

  • Chiropractor
  • Saint Cloud, FL
National Provider Identifier
1013121011
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X010111 Issued in NY
Practice address
2090 Old Hickory Tree Rd Ste 107
Saint Cloud, FL 34772-8901
Phone
(407) 593-1273
Fax
(352) 353-4717
NPI assigned
May 9, 2007
Last updated
Oct 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X010111 NY Primary

Addresses

Primary practice location

2090 Old Hickory Tree Rd Ste 107
Saint Cloud, FL 34772-8901

Mailing address

2090 Old Hickory Tree Rd Ste 107
Saint Cloud, FL 34772-8901
Phone (407) 593-1273

Other practice location 1

2466 N Jerusalem Rd
North Bellmore, NY 11710-1107
Phone (516) 316-2032

Other identifiers 1

IdentifierTypeStateIssuer
C10111-5WOtherNYWORKERS COMPENSATION

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250114001886 FL Practitioner - Chiropractic 9032108436 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2090 Old Hickory Tree Rd
Saint Cloud, FL 34772-8901
Phone (407) 593-1273

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X010111NYMDChiropractor
010111NYMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Welcome to Wellness Inc Chiropractor CurrentSince Oct 9, 2024 Accepting new patients

Locations

2090 Old Hickory Tree Rd
Ste 107
Saint Cloud, FL 34772
Phone (407) 593-1273

Organizations & group practices 1

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": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1013121011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2090 OLD HICKORY TREE RD STE 107",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347728901",
            "telephone_number": "407-593-1273",
            "fax_number": "352-353-4717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2090 OLD HICKORY TREE RD STE 107",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347728901",
            "telephone_number": "407-593-1273",
            "fax_number": "352-353-4717"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2466 N Jerusalem Rd",
            "address_purpose": "LOCATION",
            "city": "North Bellmore",
            "state": "NY",
            "postal_code": "117101107",
            "country_code": "US",
            "telephone_number": "516-316-2032",
            "fax_number": "352-353-4717",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOCCIO",
        "first_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-09",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X010111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS COMPENSATION",
            "identifier": "C10111-5W",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.