John Crocirto Gavencak, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

X010539 Issued in NY

Practice address

326 Main St
Center Moriches, NY 11934-3509

Phone

(631) 399-8888

NPI assigned

Oct 4, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Chiropractic

Education

New York Chiropractic College, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: john@jgcp0001.direct.chirotouch.md

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234224000000",
    "number": "1104911262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 MAIN ST",
            "city": "CENTER MARICHES",
            "state": "NY",
            "postal_code": "11934",
            "telephone_number": "631-399-8888",
            "fax_number": "631-399-3246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 MAIN ST",
            "city": "CENTER MORICHES",
            "state": "NY",
            "postal_code": "119343509",
            "telephone_number": "631-399-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAVENCAK",
        "first_name": "JOHN",
        "middle_name": "CROCIRTO",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2009-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X010539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Flanagan, LCSW-R
• Sue Ann Fratello
• Valerie Frederick
• Valerie Marie Galletta, LMSW
• Kathleen Ganun, RN
• Christianne Gentry
• Jacqueline Grace Gil, RPA-C
• David T Goldman, M.D.
• Egda M Gonzalez, LMSW
• Jose A. Gonzalez Jr., DC DPT

• Chiropractor in Center Moriches, NY
• Providers in Center Moriches, NY by specialty
• Chiropractor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2009; 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.