Individual provider Active NPI

Stephen Michael Garofalo, D.C.

  • Chiropractor
  • Philadelphia, PA
National Provider Identifier
1093882474
Registry record updated Mar 27, 2024
On this page

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128a(3) exclusion effective Apr 18, 2013.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC005542L Issued in PA
Practice address
6404 Roosevelt Blvd
Suite 1C
Philadelphia, PA 19149-9998
Phone
(267) 788-1789
Fax
(215) 437-1407
NPI assigned
Nov 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X DC005542L PA Primary

Addresses

Primary practice location

6404 Roosevelt Blvd
Suite 1C
Philadelphia, PA 19149-9998

Mailing address

6404 Roosevelt Blvd Ste 1C-3
Philadelphia, PA 19149-2943
Phone (267) 788-1789

Other names 1

  • Dr. Stephen Michael Rios Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
DC005542LPAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Health & Wellness LLC Chiropractor CurrentSince Mar 1, 2024 Accepting new patients
Metro Health and Wellness Single Specialty PastSince Mar 31, 2024 Accepting new patients

Locations

6404 Roosevelt Blvd
Ste 1C3
Philadelphia, PA 19149
Phone (267) 788-1789

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": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1093882474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6404 ROOSEVELT BLVD STE 1C-3",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191492943",
            "telephone_number": "267-788-1789",
            "fax_number": "215-437-1407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6404 ROOSEVELT BLVD",
            "address_2": "SUITE 1C",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191499998",
            "telephone_number": "267-788-1789",
            "fax_number": "215-437-1407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAROFALO",
        "first_name": "STEPHEN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC005542L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHEN",
            "last_name": "RIOS",
            "middle_name": "MICHAEL",
            "prefix": "DR.",
            "credential": "D.C.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.