Individual provider Active NPI

Eric Thomas Dimartino, DC

  • Chiropractor
  • Chesterfield, MI
National Provider Identifier
1124047873
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301008534 Issued in MI
Practice address
30120 23 Mile Rd
Chesterfield, MI 48047-2190
Phone
(586) 949-9248
Fax
(586) 949-6048
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301008534 MI Primary

Addresses

Primary practice location

30120 23 Mile Rd
Chesterfield, MI 48047-2190

Mailing address

30120 23 Mile Rd
Chesterfield, MI 48047-2190
Phone (586) 949-9248

Other identifiers 1

IdentifierTypeStateIssuer
4590504MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120521000410 MI Practitioner - Chiropractic 7719985506 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dimartino Chiropractic Center, PCGroup PAC ID 3173521960, 3 clinicians

Practice addresses (Care Compare)

30120 23 Mile Rd
Chesterfield, MI 48047-2190
Phone (586) 949-9248

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dimartino Livonia PC Chiropractor CurrentSince Jun 1, 2021 Accepting new patients
Dimartino Chiropractic Center, PC Chiropractor CurrentSince Aug 1, 2003 Accepting new patients
American Chiropractic Medical Services LLC Chiropractor Past Accepting new patients
Deanda Chiropractic Clinic LLC Chiropractor Past Accepting new patients

Locations

30120 23 Mile Rd
Chesterfield, MI 48047
Phone (586) 949-9248

Organizations & group practices 4

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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124047873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30120 23 MILE RD",
            "city": "CHESTERFIELD",
            "state": "MI",
            "postal_code": "480472190",
            "telephone_number": "586-949-9248",
            "fax_number": "586-949-6048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30120 23 MILE RD",
            "city": "CHESTERFIELD",
            "state": "MI",
            "postal_code": "480472190",
            "telephone_number": "586-949-9248",
            "fax_number": "586-949-6048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMARTINO",
        "first_name": "ERIC",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301008534",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4590504",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.