Individual provider Active NPI

Miles Tsujimoto, DC

  • Chiropractor
  • Arcadia, CA
National Provider Identifier
1104541127
Registry record updated Oct 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC36442 Issued in CA
Practice address
638 W Duarte Rd Ste 16
Arcadia, CA 91007-7672
Phone
(626) 447-0447
NPI assigned
Oct 12, 2022
Sex
Male
Sole proprietor
No

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.

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3660 S 900
Apt 304
Millcreek, UT 84106-2080

458 N 500
Bountiful, UT 84010-6948

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250815002473 UT Practitioner - Chiropractic 7719355858 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC36442CAMDChiropractor

Practice roles (3 of 5)

OrganizationSpecialtyStatusNew patients
Integrated Functional Medicine, LLC CurrentSince May 11, 2025 Accepting new patients
Clarizio Chiropratic Inc CurrentSince Oct 1, 2022 Accepting new patients
Integrated Functional Medicine CurrentSince May 11, 2025 Accepting new patients

Locations

638 W Duarte Rd
Ste 16
Arcadia, CA 91007
Phone (626) 340-3742

458 N 500 W
Bountiful, UT 84010
Phone (801) 292-9355

Networks

  • UT PPO D-SNP
  • UT PPO

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC36442 CA Primary

Addresses

NPPES NPI Registry

Primary practice location

638 W Duarte Rd Ste 16
Arcadia, CA 91007-7672

Mailing address

638 W Duarte Rd Ste 16
Arcadia, CA 91007-7672
Phone (626) 447-0447

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 12, 2022.

{
    "created_epoch": "1665532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665532800000",
    "number": "1104541127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "638 W DUARTE RD STE 16",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910077672",
            "telephone_number": "626-447-0447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "638 W DUARTE RD STE 16",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910077672",
            "telephone_number": "626-447-0447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSUJIMOTO",
        "first_name": "MILES",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-12",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC36442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arcadia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2022; 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.