Individual provider Active NPI

Michael John Risoldi, D.C.

  • Chiropractor
  • Clearwater, FL
National Provider Identifier
1083778724
Registry record updated Nov 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH7449 Issued in FL
Practice address
3023 Eastland Blvd
Clearwater, FL 33761-4106
Phone
(727) 797-9900
NPI assigned
Dec 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH7449 FL Primary

Addresses

Primary practice location

3023 Eastland Blvd
Clearwater, FL 33761-4106

Mailing address

3023 Eastland Blvd Ste 101
Clearwater, FL 33761-4106
Phone (727) 797-9900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071219000140 FL Practitioner - Chiropractic 4789774498 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3023 Eastland Blvd
H101
Clearwater, FL 33761-4106
Phone (727) 797-9900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH7449FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Risoldi Family Chiropractic PA Chiropractor CurrentSince Nov 1, 2007 Accepting new patients
Champion Wellness of Haines City, LLC Chiropractor Current Accepting new patients

Locations

3023 Eastland Blvd
Ste 101
Clearwater, FL 33761
Phone (727) 797-9900

3023 Eastland Blvd
#H101
Clearwater, FL 33761
Phone (727) 797-9900

3023 Eastland Blvd
Unit H101
Clearwater, FL 33761
Phone (727) 797-9900

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193875200000",
    "number": "1083778724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3023 EASTLAND BLVD STE 101",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337614106",
            "telephone_number": "727-797-9900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3023 EASTLAND BLVD",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337614106",
            "telephone_number": "727-797-9900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RISOLDI",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-20",
        "last_updated": "2007-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH7449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2007; 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.