Individual provider Active NPI

Joseph Patrick Mikluscak Jr., D.C.

  • Chiropractor
  • Manassas, VA
National Provider Identifier
1134268774
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104556055 Issued in VA
Practice address
10055 Wellington Rd
Manassas, VA 20110-7805
Phone
(703) 257-2555
Fax
(703) 257-2556
NPI assigned
Feb 6, 2007
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 0104556055 VA Primary

Addresses

Primary practice location

10055 Wellington Rd
Manassas, VA 20110-7805

Mailing address

8864 Yellow Hammer Dr
Gainesville, VA 20155-5851
Phone (571) 239-8230

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041210000411 VA Practitioner - Chiropractic 6002873163 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9401 Centreville Rd
Suite 102
Manassas, VA 20110-5107
Phone (703) 257-2555

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0104556055VAMDChiropractor

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": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1134268774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8864 YELLOW HAMMER DR",
            "city": "GAINESVILLE",
            "state": "VA",
            "postal_code": "201555851",
            "telephone_number": "571-239-8230",
            "fax_number": "703-257-2556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10055 WELLINGTON RD",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201107805",
            "telephone_number": "703-257-2555",
            "fax_number": "703-257-2556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKLUSCAK",
        "first_name": "JOSEPH",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104556055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manassas, VA

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.