Organization Active NPI

Bellport Chiropractic, P.C.

  • Chiropractor
  • Bellport, NY
National Provider Identifier
1093966327
Registry record updated Sep 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X008989 Issued in NY
Legal business name
BELLPORT CHIROPRACTIC, P.C.
Practice address
112 S Country Rd
Suite 103
Bellport, NY 11713-2534
Phone
(631) 286-9410
Fax
(631) 286-6491
NPI assigned
Oct 6, 2008
Last updated
Sep 14, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2009

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

Authorized official

Name
Dr. Michael John Stuto, D.C.NPI 1194721779
Title
Chiropractor/ President
Phone
(631) 286-9410

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X008989 NY Primary

Addresses

Primary practice location

112 S Country Rd
Suite 103
Bellport, NY 11713-2534

Mailing address

112 S Country Rd
Suite 103
Bellport, NY 11713-2534
Phone (631) 286-9410

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081124000269 NY Part B Supplier - Clinic/Group Practice 9436219276 Receives reassigned benefits from 1 practitioner
Practice locations: Bellport, NY

National Provider Directory

National Provider Directory

Locations

112 S Country Rd
Ste 103
Bellport, NY 11713
Phone (631) 286-9410

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1223251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252886400000",
    "number": "1093966327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 S COUNTRY RD",
            "address_2": "SUITE 103",
            "city": "BELLPORT",
            "state": "NY",
            "postal_code": "117132534",
            "telephone_number": "631-286-9410",
            "fax_number": "631-286-6491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 S COUNTRY RD",
            "address_2": "SUITE 103",
            "city": "BELLPORT",
            "state": "NY",
            "postal_code": "117132534",
            "telephone_number": "631-286-9410",
            "fax_number": "631-286-6491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLPORT CHIROPRACTIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-06",
        "last_updated": "2009-09-14",
        "status": "A",
        "authorized_official_last_name": "STUTO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "CHIROPRACTOR/ PRESIDENT",
        "authorized_official_telephone_number": "631-286-9410",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X008989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2009; 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.