Individual provider Active NPI

Dino Gerard Mazzara, D.C.

  • Chiropractor
  • Syracuse, NY
National Provider Identifier
1104999457
Registry record updated Feb 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
XOOO8584 Issued in NY
Practice address
600 E Genesee St
Suite 114
Syracuse, NY 13202-3130
Phone
(315) 314-7129
Fax
(315) 314-7133
NPI assigned
Nov 16, 2006
Last updated
Feb 25, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X XOOO8584 NY Primary

Addresses

Primary practice location

600 E Genesee St
Suite 114
Syracuse, NY 13202-3130

Mailing address

600 E Genesee St
Suite 114
Syracuse, NY 13202-3130
Phone (315) 314-7129

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040402000323 NY Practitioner - Chiropractic 4284626722 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
High Point Chiropractic Wellness, P.C.Group PAC ID 4082899422, 3 clinicians

Practice addresses (Care Compare)

1732 W Genesee St
Syracuse, NY 13204-1902
Phone (315) 214-8100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
XOOO8584NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
High Point Chiropractic Wellness PC Chiropractor CurrentSince Nov 9, 2021 Accepting new patients
Jahn Chiropractic PC Chiropractor Past Accepting new patients

Locations

1732 W Genesee St
Syracuse, NY 13204
Phone (315) 214-8100

Interoperability endpoints

  • Direct secure messaging: dinomazzara@nysw.allscriptsdirect.net

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": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330128000000",
    "number": "1104999457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 E GENESEE ST",
            "address_2": "SUITE 114",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132023130",
            "telephone_number": "315-314-7129",
            "fax_number": "315-314-7133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 E GENESEE ST",
            "address_2": "SUITE 114",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132023130",
            "telephone_number": "315-314-7129",
            "fax_number": "315-314-7133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZZARA",
        "first_name": "DINO",
        "middle_name": "GERARD",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-16",
        "last_updated": "2012-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "XOOO8584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2012; 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.