Individual provider Active NPI

Cory Sieniawski

  • Chiropractor
  • Medina, OH
National Provider Identifier
1114481520
Registry record updated Apr 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC-04863 Issued in OH
Practice address
3591 Reserve Commons Dr Ste 100
Medina, OH 44256-5334
Phone
(330) 721-6504
NPI assigned
Jan 30, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC-04863 OH Primary

Addresses

Primary practice location

3591 Reserve Commons Dr Ste 100
Medina, OH 44256-5334

Mailing address

39875 Jones Rd
Wellington, OH 44090-9039
Phone (330) 461-1522

Other practice location 1

2620 W Market St
Akron, OH 44313-4204
Phone (330) 869-6566

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190817000186 OH Practitioner - Chiropractic 4688902497 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Spine Joint and Wellness CenterGroup PAC ID 6103066089, 4 clinicians

Practice addresses (Care Compare)

5020 Victor Dr
Medina, OH 44256-9688
Phone (330) 721-6504

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Spine Joint and Wellness Center CurrentSince Jun 1, 2019 Accepting new patients
Minorik Health and Wellness Center Inc PastSince Feb 25, 2016 Accepting new patients
Minorik Chiropractic Center Chiropractor Past Accepting new patients

Locations

5020 Victor Dr
Medina, OH 44256
Phone (330) 433-4243

3591 Reserve Commons Dr
Ste 100
Medina, OH 44256
Phone (330) 721-6504

401 Congress Ave
Ste 1540
Austin, TX 78701
Phone (512) 308-6342

Organizations & group practices 3

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": "1548806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554768000000",
    "number": "1114481520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39875 JONES RD",
            "city": "WELLINGTON",
            "state": "OH",
            "postal_code": "440909039",
            "telephone_number": "330-461-1522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3591 RESERVE COMMONS DR STE 100",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442565334",
            "telephone_number": "330-721-6504"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2620 W Market St",
            "address_purpose": "LOCATION",
            "city": "Akron",
            "state": "OH",
            "postal_code": "443134204",
            "country_code": "US",
            "telephone_number": "330-869-6566",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIENIAWSKI",
        "first_name": "CORY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-30",
        "last_updated": "2019-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "DC-04863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medina, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2019; 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.