Individual provider Active NPI

Emanuel N Tsourounakis, DC

  • Chiropractor
  • Elmhurst, NY
National Provider Identifier
1134213911
Registry record updated Nov 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2885 Issued in NY
Practice address
91 31 Queens Boulevard
Suite 304
Elmhurst, NY 11373
Phone
(718) 507-5581
Fax
(718) 507-5075
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2885 NY Primary

Addresses

Primary practice location

91 31 Queens Boulevard
Suite 304
Elmhurst, NY 11373

Mailing address

91 31 Queens Boulevard
Suite 304
Elmhurst, NY 11373
Phone (718) 507-5581

Other identifiers 1

IdentifierTypeStateIssuer
02220006MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091205000088 NY Practitioner - Chiropractic 6507905445 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9131 Queens Blvd
Suite 304
Elmhurst, NY 11373-5540
Phone (718) 507-5581

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2885NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Queens Center Chiropractic PC CurrentSince Nov 16, 1990 Accepting new patients

Locations

9131 Queens Blvd
Ste 304
Flushing, NY 11373
Phone (718) 507-5581

Organizations & group practices 1

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289520000000",
    "number": "1134213911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 31 QUEENS BOULEVARD",
            "address_2": "SUITE 304",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "11373",
            "telephone_number": "718-507-5581",
            "fax_number": "718-507-5075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 31 QUEENS BOULEVARD",
            "address_2": "SUITE 304",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "11373",
            "telephone_number": "718-507-5581",
            "fax_number": "718-507-5075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSOUROUNAKIS",
        "first_name": "EMANUEL",
        "middle_name": "N",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2010-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "2885",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02220006",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2010; 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.