Individual provider Active NPI

Roxanne M Dziedzic, DC

  • Chiropractor
  • Alden, NY
National Provider Identifier
1104868132
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X008435 Issued in NY
Practice address
13305 Broadway St
Alden, NY 14004-1324
Phone
(716) 937-4577
Fax
(716) 937-7535
NPI assigned
Jun 12, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X008435 NY Primary

Addresses

Primary practice location

13305 Broadway St
Alden, NY 14004-1324

Mailing address

13305 Broadway St
Alden, NY 14004-1324
Phone (716) 937-4577

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
X008435NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Stephanie Pautler-Bea, D.C., P.C. Chiropractor PastSince Nov 24, 2014 Accepting new patients
Scott D Banks DC PC Chiropractor Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1104868132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13305 BROADWAY ST",
            "city": "ALDEN",
            "state": "NY",
            "postal_code": "140041324",
            "telephone_number": "716-937-4577",
            "fax_number": "716-937-7535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13305 BROADWAY ST",
            "city": "ALDEN",
            "state": "NY",
            "postal_code": "140041324",
            "telephone_number": "716-937-4577",
            "fax_number": "716-937-7535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DZIEDZIC",
        "first_name": "ROXANNE",
        "middle_name": "M",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X008435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alden, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.