Individual provider Active NPI

Linda M Bocchichio, DC

  • Chiropractor
  • Nesconset, NY
National Provider Identifier
1083709828
Registry record updated Aug 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X004807-1 Issued in NY
Practice address
105 Lake Ave S
Nesconset, NY 11767-1049
Phone
(631) 979-9854
Fax
(631) 366-0084
NPI assigned
Oct 4, 2006
Last updated
Aug 11, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X004807-1 NY Primary

Addresses

Primary practice location

105 Lake Ave S
Nesconset, NY 11767-1049

Mailing address

105 Lake Ave S
Nesconset, NY 11767-1049
Phone (631) 979-9854

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110324000504 NY Practitioner - Chiropractic 7416130752 Practice locations: Nesconset, NY

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

105 Lake Ave S
Nesconset, NY 11767-1049

105 Lake Ave So
Nesconset, NY 11767-1049
Phone (631) 979-9854

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X004807-1NYMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281484800000",
    "number": "1083709828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 LAKE AVE S",
            "city": "NESCONSET",
            "state": "NY",
            "postal_code": "117671049",
            "telephone_number": "631-979-9854",
            "fax_number": "631-366-0084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 LAKE AVE S",
            "city": "NESCONSET",
            "state": "NY",
            "postal_code": "117671049",
            "telephone_number": "631-979-9854",
            "fax_number": "631-366-0084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOCCHICHIO",
        "first_name": "LINDA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2010-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X004807-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nesconset, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2010; 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.