Active NPI
Matthew Jonathan Sanicki, D.C.
- Chiropractor
- San Diego, CA
National Provider Identifier
1114137361
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC28735
- Practice address
- 2751 Roosevelt Rd
Building 210, Suite 203
San Diego, CA 92106-6180 - Phone
- (619) 795-2224
- Fax
- (619) 793-5517
- NPI assigned
- May 23, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC28735 | CA | Primary |
Addresses
Primary practice location
2751 Roosevelt Rd
Building 210, Suite 203
San Diego, CA 92106-6180
Mailing address
2902 Poinsettia Dr
San Diego, CA 92106-1128
Phone (619) 501-1673
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Coulsby Chiropractic, P.C. | Past | Accepting new patients | |
| Matthew Sanicki Chiropractic Inc | 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 and National Provider Directory roles.
-
- Chiropractor
- San Diego, CA
- NPI 1538604293
-
- Sports Physician Chiropractor
- San Diego, CA
- NPI 1790115558
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1251072000000",
"number": "1114137361",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2902 POINSETTIA DR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921061128",
"telephone_number": "619-501-1673",
"fax_number": "619-299-2212"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2751 ROOSEVELT RD",
"address_2": "BUILDING 210, SUITE 203",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921066180",
"telephone_number": "619-795-2224",
"fax_number": "619-793-5517"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANICKI",
"first_name": "MATTHEW",
"middle_name": "JONATHAN",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-23",
"last_updated": "2009-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC28735",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.