Individual provider Active NPI

Brendan Patrick Corcoran, D.C.

  • Chiropractor
  • Winthrop, MA
National Provider Identifier
1093813396
Registry record updated Jul 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2851 Issued in MA
Practice address
11 Bartlett Rd
Winthrop, MA 02152-2912
Phone
(617) 846-3502
Fax
(617) 846-6899
NPI assigned
Sep 20, 2006
Last updated
Jul 28, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2851 MA Primary

Addresses

Primary practice location

11 Bartlett Rd
Winthrop, MA 02152-2912

Mailing address

121 Maplewood Ave
Unit #2
Gloucester, MA 01930-2659
Phone (617) 846-3502

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041018001092 MA Practitioner - Chiropractic 7416917919 Practice locations: Gloucester, MA; Winthrop, MA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6 Bartlett Rd
Winthrop, MA 02152-2913
Phone (617) 846-3502

85 Eastern Ave
Suite 209
Gloucester, MA 01930-6517
Phone 97828211912

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2851MAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Cummings Physical Therapy, Inc CurrentSince Oct 14, 2015 Accepting new patients
Spine Center North Shore LLC Chiropractor PastSince Oct 14, 2015 Accepting new patients
Merolla Chiropractic Inc Chiropractor Past Accepting new patients

Locations

11 Bartlett Rd
Winthrop, MA 02152
Phone (617) 846-0832

6 Bartlett Rd
Winthrop, MA 02152
Phone (617) 846-0832

Organizations & group practices 3

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217203200000",
    "number": "1093813396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 MAPLEWOOD AVE",
            "address_2": "UNIT #2",
            "city": "GLOUCESTER",
            "state": "MA",
            "postal_code": "019302659",
            "telephone_number": "617-846-3502",
            "fax_number": "617-846-6899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 BARTLETT RD",
            "city": "WINTHROP",
            "state": "MA",
            "postal_code": "021522912",
            "telephone_number": "617-846-3502",
            "fax_number": "617-846-6899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORCORAN",
        "first_name": "BRENDAN",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2008-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "2851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winthrop, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2008; 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.