Individual provider Active NPI

Christopher A Dicarlo, DC

  • Chiropractor
  • Hollywood, FL
National Provider Identifier
1033228721
Registry record updated Sep 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH7202 Issued in FL
Practice address
2415 Hollywood Blvd
Hollywood, FL 33020-6605
Phone
(954) 456-0250
Fax
(954) 456-0820
NPI assigned
Aug 29, 2006
Last updated
Sep 19, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH7202 FL Primary

Addresses

Primary practice location

2415 Hollywood Blvd
Hollywood, FL 33020-6605

Mailing address

2415 Hollywood Blvd
Hollywood, FL 33020-6605
Phone (954) 456-0250

Other identifiers 2

IdentifierTypeStateIssuer
8464021OtherFLCIGNA
55483OtherFLBCBS OF FL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120727000670 FL Practitioner - Chiropractic 0648436147 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Total Healthcare IncGroup PAC ID 8022058346, 5 clinicians

Practice addresses (Care Compare)

2415 Hollywood Blvd
Hollywood, FL 33020-6605
Phone (954) 456-0250

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH7202FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Total Healthcare Inc Chiropractor CurrentSince Jan 1, 2000 Accepting new patients
Imed Advisory LLC Past Accepting new patients

Locations

1250 E Hallandale Beach Blvd
Ste 205
Hallandale Beach, FL 33009
Phone (954) 456-0250

2415 Hollywood Blvd
Hollywood, FL 33020
Phone (954) 456-0250

Organizations & group practices 2

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": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474243200000",
    "number": "1033228721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2415 HOLLYWOOD BLVD",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330206605",
            "telephone_number": "954-456-0250",
            "fax_number": "954-456-0820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2415 HOLLYWOOD BLVD",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330206605",
            "telephone_number": "954-456-0250",
            "fax_number": "954-456-0820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICARLO",
        "first_name": "CHRISTOPHER",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2016-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH7202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "8464021",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FL",
            "identifier": "55483",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2016; 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.