Active NPI
Christopher David Czernicki, DC
- Chiropractor
- Shrewsbury, MA
National Provider Identifier
1063161099
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CHI3799
- Practice address
- 415 Boston Tpke
Shrewsbury, MA 01545-3446 - Phone
- (888) 926-1223
- NPI assigned
- Mar 18, 2022
- Last updated
- Jan 16, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CHI3799 | MA | Primary |
Addresses
Primary practice location
415 Boston Tpke
Shrewsbury, MA 01545-3446
Mailing address
415 Boston Tpke
Shrewsbury, MA 01545-3446
Other practice location 1
123 Summer St Ste 320S
Worcester, MA 01608-1216
Phone (508) 964-5580
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CHI3799 | MA | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Reliant Medical Group, Inc | Past | Accepting new patients |
Interoperability endpoints
- christopher.czernicki.npi1063161099.reliant@direct.optumcare.masshiway.net
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.
-
- Physical Therapist
- Worcester, MA
- NPI 1295827962
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1647561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705363200000",
"number": "1063161099",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "415 BOSTON TPKE",
"city": "SHREWSBURY",
"state": "MA",
"postal_code": "015453446"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "415 BOSTON TPKE",
"city": "SHREWSBURY",
"state": "MA",
"postal_code": "015453446",
"telephone_number": "888-926-1223"
}
],
"practiceLocations": [
{
"address_1": "123 Summer St Ste 320S",
"address_purpose": "LOCATION",
"city": "Worcester",
"state": "MA",
"postal_code": "016081216",
"country_code": "US",
"telephone_number": "508-964-5580",
"fax_number": "508-368-3143",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CZERNICKI",
"first_name": "CHRISTOPHER",
"middle_name": "DAVID",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-03-18",
"last_updated": "2024-01-16",
"certification_date": "2024-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MA",
"license": "CHI3799",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shrewsbury, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.