Individual provider Active NPI

Richard W Disanti, DC

  • Chiropractor
  • Russellton, PA
National Provider Identifier
1063487205
Registry record updated Apr 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC001778L Issued in PA
Practice address
715 Little Deer Creek Valley Rd
Russellton, PA 15076-0064
Phone
(724) 265-2100
Fax
(724) 265-2122
NPI assigned
Feb 21, 2006
Last updated
Apr 22, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC001778L PA Primary

Addresses

Primary practice location

715 Little Deer Creek Valley Rd
Russellton, PA 15076-0064

Mailing address

715 Little Deer Creek Valley Rd
Russellton, PA 15076-0064
Phone (724) 265-2100

Other identifiers 1

IdentifierTypeStateIssuer
1501577MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040712001005 PA Practitioner - Chiropractic 1951389337 Receives reassigned benefits from 1 practitioner
Practice locations: Lower Burrell, PA; Russellton, PA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National University of Arts and Sciences, Medical Department, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

715 Little Deer Creek Valley Rd
Russellton, PA 15076-0064

715 Little Deer Creek Valley Rd
Russellton, PA 15076-1312
Phone (724) 265-2100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Allegheny Valley Chiropractic Associates Chiropractor PastSince Jan 1, 1990 Accepting new patients
Allegheny Valley Chiropractic Associates Chiropractor PastSince Jan 1, 1990 Accepting new patients

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

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": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303430400000",
    "number": "1063487205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 LITTLE DEER CREEK VALLEY RD",
            "city": "RUSSELLTON",
            "state": "PA",
            "postal_code": "150760064",
            "telephone_number": "724-265-2100",
            "fax_number": "724-265-2122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 LITTLE DEER CREEK VALLEY RD",
            "city": "RUSSELLTON",
            "state": "PA",
            "postal_code": "150760064",
            "telephone_number": "724-265-2100",
            "fax_number": "724-265-2122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISANTI",
        "first_name": "RICHARD",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2011-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC001778L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1501577",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Russellton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2011; 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.