Individual provider Active NPI

Daniel Scott Halajcsik, D.C.

  • Chiropractor
  • Fort Myers, FL
National Provider Identifier
1124204359
Registry record updated Aug 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH 9473 Issued in FL
Practice address
4350 Fowler St Ste 1B
Suite 101
Fort Myers, FL 33901-2616
Phone
(239) 561-3838
NPI assigned
Jan 17, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH 9473 FL Primary

Addresses

Primary practice location

4350 Fowler St Ste 1B
Suite 101
Fort Myers, FL 33901-2616

Mailing address

4350 Fowler St Ste 1B
Suite 101
Fort Myers, FL 33901-2616
Phone (239) 561-3838

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080421000075 FL Practitioner - Chiropractic 4688752413 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4350 Fowler St
Suite 1B
Fort Myers, FL 33901-2616
Phone (239) 561-3838

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH 9473FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Halajcsik Chiropractic Clinic PA Chiropractor CurrentSince Jan 28, 2008 Accepting new patients
LG Rehab Center, Inc Past Accepting new patients

Locations

4350 Fowler St
Ste 1B
Fort Myers, FL 33901
Phone (239) 466-8889

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.

NPI Registry JSON

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

{
    "created_epoch": "1200528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472515200000",
    "number": "1124204359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4350 FOWLER ST STE 1B",
            "address_2": "SUITE 101",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339012616",
            "telephone_number": "239-561-3838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4350 FOWLER ST STE 1B",
            "address_2": "SUITE 101",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339012616",
            "telephone_number": "239-561-3838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALAJCSIK",
        "first_name": "DANIEL",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-17",
        "last_updated": "2016-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH 9473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2016; 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.