Individual provider Active NPI

Ronald John Delaire, DC

  • Chiropractor
  • Cathedral City, CA
National Provider Identifier
1104889492
Registry record updated May 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC21666 Issued in CA
Practice address
27620 Landau Blvd
Ste. 1
Cathedral City, CA 92234-5540
Phone
(760) 320-4123
Fax
(760) 320-0801
NPI assigned
Apr 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 21666 CA
Chiropractor 111N00000X DC21666 CA Primary

Addresses

Primary practice location

27620 Landau Blvd
Ste. 1
Cathedral City, CA 92234-5540

Mailing address

27620 Landau Blvd
Ste. 1
Cathedral City, CA 92234-5540
Phone (760) 320-4123

Other names 1

  • Ronald Delaire Professional name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031212000827 CA Practitioner - Chiropractic 2365349917 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Canadian Memorial Chiropractic College, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

27620 Landau Blvd
Suite 1
Cathedral City, CA 92234-5540
Phone (760) 320-4123

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Delaire Chiropractic Clinic Inc Chiropractor CurrentSince Nov 3, 2015 Accepting new patients
Eisenhower Medical Center PastSince Dec 3, 2015 Accepting new patients

Locations

27620 Landau Blvd
Ste 1
Cathedral Cty, CA 92234
Phone (760) 320-4123

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1144454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715299200000",
    "number": "1104889492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27620 LANDAU BLVD",
            "address_2": "STE. 1",
            "city": "CATHEDRAL CITY",
            "state": "CA",
            "postal_code": "922345540",
            "telephone_number": "760-320-4123",
            "fax_number": "760-320-0801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27620 LANDAU BLVD",
            "address_2": "STE. 1",
            "city": "CATHEDRAL CITY",
            "state": "CA",
            "postal_code": "922345540",
            "telephone_number": "760-320-4123",
            "fax_number": "760-320-0801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELAIRE",
        "first_name": "RONALD",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-08",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "21666",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC21666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RONALD",
            "last_name": "DELAIRE",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Cathedral City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2024; 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.