Maria Teresa Gomez Sirucek, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIA-1370 Issued in ID

Practice address

3080 E Gentry Way
Suite 110
Meridian, ID 83642-3544

Phone

(208) 345-7262

Fax

(208) 343-1953

NPI assigned

Jul 8, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College - West, 2009

Medicare assignment

May accept Medicare assignment

Group practices

Sirucek Chiropractic Neurology Clinic IncGroup PAC ID 3072660729, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Sirucek Chiropractic Neurology Clinic, Inc.

  • Neurology Chiropractor
  • Meridian, ID
  • NPI 1093975302
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1247011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357776000000",
    "number": "1104055383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3080 E GENTRY WAY",
            "address_2": "SUITE 110",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836423544",
            "telephone_number": "208-345-7262",
            "fax_number": "208-343-1953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3080 E GENTRY WAY",
            "address_2": "SUITE 110",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836423544",
            "telephone_number": "208-345-7262",
            "fax_number": "208-343-1953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIRUCEK",
        "first_name": "MARIA TERESA",
        "middle_name": "GOMEZ",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-08",
        "last_updated": "2013-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-1370",
            "primary": true
        },
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "ID",
            "license": "CHIA-1370",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093975302",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Russell Neal Singleton, PA-C
• Kartika Singpraseuth, PHARMD
• Sinus Surgery Center Idaho PA
• Sirucek Chiropractic Neurology Clinic, Inc.
• Dax Sirucek, DC, DACNB
• Sisc Anesthesia Inc
• Amanda Sissom
• Kelly Siudzinski, M.D.
• Brandon Skanderup
• Amanda Kay Skarban

• Chiropractor in Meridian, ID
• Providers in Meridian, ID by specialty
• Chiropractor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2013; 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.