Individual provider Active NPI

Brenda Rose Basconcillo Ramos, D.C.

  • Chiropractor
  • Antioch, CA
National Provider Identifier
1093959702
Registry record updated Jun 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC-31220 Issued in CA
Practice address
3700 Delta Fair Blvd Ste L
Antioch, CA 94509
Phone
(925) 778-3288
Fax
(925) 778-2410
NPI assigned
Apr 24, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC-31220 CA Primary

Addresses

Primary practice location

3700 Delta Fair Blvd Ste L
Antioch, CA 94509

Mailing address

3700 Delta Fair Blvd Ste L
Antioch, CA 94509-4075
Phone (925) 778-3288

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120523000251 CA Practitioner - Chiropractic 6709049133 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC-31220CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Heifetz Chiropractic Inc Chiropractor Past Accepting new patients
Ramos & Hatch Chiropractic Chiropractor PastSince Dec 9, 2018 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1240531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528416000000",
    "number": "1093959702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 DELTA FAIR BLVD STE L",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945094075",
            "telephone_number": "925-778-3288",
            "fax_number": "925-778-2410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 DELTA FAIR BLVD STE L",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "94509",
            "telephone_number": "925-778-3288",
            "fax_number": "925-778-2410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMOS",
        "first_name": "BRENDA ROSE",
        "middle_name": "BASCONCILLO",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-24",
        "last_updated": "2018-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC-31220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Antioch, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.