Individual provider Active NPI

Michael Jon Pagliacci, D.C.

  • Rehabilitation Chiropractor
  • Scottdale, PA
National Provider Identifier
1073711610
Registry record updated Jan 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
DC009392 Issued in PA
Practice address
17 N Chestnut St
Scottdale, PA 15683-1714
Phone
(724) 887-7269
NPI assigned
Jul 5, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Chiropractor 111NR0400X DC009392 PA Primary

Addresses

Primary practice location

17 N Chestnut St
Scottdale, PA 15683-1714

Mailing address

17 N Chestnut St
Scottdale, PA 15683-1714
Phone (724) 970-9931

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070827000744 PA Practitioner - ChiropracticPractitioner - Physical Medicine and Rehabilitation 8921190554 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
ChiropracticAlso: Physical Medicine and Rehabilitation
Education
Palmer College Chiropractic - Davenport, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

17 N Chestnut St
Scottdale, PA 15683-1714
Phone (724) 970-9931

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC009392PAMDRehabilitation Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Fountain Mills Chiropractic, LLC Rehabilitation CurrentSince Aug 16, 2007 Accepting new patients

Locations

17 N Chestnut St
Scottdale, PA 15683
Phone (724) 887-7269

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": "1183593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579046400000",
    "number": "1073711610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 N CHESTNUT ST",
            "city": "SCOTTDALE",
            "state": "PA",
            "postal_code": "156831714",
            "telephone_number": "724-970-9931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 N CHESTNUT ST",
            "city": "SCOTTDALE",
            "state": "PA",
            "postal_code": "156831714",
            "telephone_number": "724-887-7269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAGLIACCI",
        "first_name": "MICHAEL",
        "middle_name": "JON",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-05",
        "last_updated": "2020-01-15",
        "certification_date": "2020-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "PA",
            "license": "DC009392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottdale, PA

Sources for this page

Verify at the official NPI Registry.