Individual provider Active NPI

Grace Ellen Konstanzer, DC

  • Chiropractor
  • Irvine, CA
National Provider Identifier
1144987363
Registry record updated Nov 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC36185 Issued in CA
Practice address
6 Venture
Irvine, CA 92618-3340
Phone
(949) 559-6030
Fax
(949) 559-6037
NPI assigned
Nov 22, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC36185 CA Primary

Addresses

Primary practice location

6 Venture
Irvine, CA 92618-3340

Mailing address

6 Venture
Irvine, CA 92618-3340
Phone (949) 559-6030

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220125002227 CA Practitioner - Chiropractic 7810389806 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2021
Medicare assignment
May accept Medicare assignment
Group practices
Disiena Family Chiropractic, a Prof CorpGroup PAC ID 0143382465, 3 clinicians

Practice addresses (Care Compare)

6 Venture
Suite 115
Irvine, CA 92618-7347
Phone (949) 559-6030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC36185CAMDChiropractor
36185CAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Disiena Family Chiropractic, a Prof Corp Chiropractor CurrentSince Nov 9, 2021 Accepting new patients

Locations

6 Venture
Ste 115
Irvine, CA 92618
Phone (949) 551-8002

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": "1637539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637539200000",
    "number": "1144987363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 VENTURE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183340",
            "telephone_number": "949-559-6030",
            "fax_number": "949-559-6037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 VENTURE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183340",
            "telephone_number": "949-559-6030",
            "fax_number": "949-559-6037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONSTANZER",
        "first_name": "GRACE",
        "middle_name": "ELLEN",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-22",
        "last_updated": "2021-11-22",
        "certification_date": "2021-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC36185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2021; 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.