Individual provider Active NPI

Charles Stefan Masarsky, DC

  • Chiropractor
  • Vienna, VA
National Provider Identifier
1073672960
Registry record updated Apr 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104000365 Issued in VA
Practice address
407 Church St NE
C
Vienna, VA 22180-4737
Phone
(703) 938-6441
Fax
(703) 319-3978
NPI assigned
Dec 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104000365 VA Primary

Addresses

Primary practice location

407 Church St NE
C
Vienna, VA 22180-4737

Mailing address

PO Box 1634
Vienna, VA 22183-1634
Phone (703) 938-6441

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110622000011 DC Practitioner - Chiropractic 4688852841 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 1981
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

243 Church St NW
Suite 300B
Vienna, VA 22180-4437
Phone (703) 938-6441

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Vienna Chiropractic Associates PC Chiropractor CurrentSince Jun 4, 2011 Accepting new patients

Locations

407 Church St NE
Ste C
Vienna, VA 22180
Phone (703) 938-6441

243 Church St NW
Ste 300B
Vienna, VA 22180
Phone (703) 242-7474

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335744000000",
    "number": "1073672960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1634",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221831634",
            "telephone_number": "703-938-6441",
            "fax_number": "703-319-3978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 CHURCH ST NE",
            "address_2": "C",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221804737",
            "telephone_number": "703-938-6441",
            "fax_number": "703-319-3978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASARSKY",
        "first_name": "CHARLES",
        "middle_name": "STEFAN",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2012-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104000365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vienna, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2012; 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.