Individual provider Active NPI

Deanna Mercedes Vallejo, DC

  • Chiropractor
  • New York, NY
National Provider Identifier
1154098549
Registry record updated Aug 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
013500 Issued in NY
Practice address
80 5TH Ave RM 1205
New York, NY 10011-8016
Phone
(212) 924-2121
NPI assigned
Aug 24, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 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 013500 NY Primary

Addresses

Primary practice location

80 5TH Ave RM 1205
New York, NY 10011-8016

Mailing address

817 Chestnut Ridge Rd
Chestnut Ridge, NY 10977-6314
Phone (845) 352-7166

Other practice location 1

817 Chestnut Ridge Rd
Chestnut Ridge, NY 10977-6314
Phone (845) 352-7166

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20211026001053 NY Practitioner - Chiropractic 3173911047 Reassigns benefits to 1 organization
I20230222000893 NJ Practitioner - Chiropractic 3173911047 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Spine and Health Center of MontvaleGroup PAC ID 8224195847, 14 clinicians

Practice addresses (Care Compare)

32 Philips Pkwy
Montvale, NJ 07645-1811
Phone (201) 746-6577

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Stephen F. Oswald, D.C., P.C. Chiropractor CurrentSince Aug 24, 2021 Accepting new patients
Spine and Health Center of Closter PC Chiropractor CurrentSince Mar 1, 2023 Accepting new patients
The Spine and Health Center of Montvale Chiropractor CurrentSince Jan 9, 2023 Accepting new patients

Locations

31 Ver Valen St
Closter, NJ 07624
Phone (201) 784-2700

32 Philips Pkwy
Montvale, NJ 07645
Phone (201) 494-4479

2 S Kinderkamack Rd
Ste 208
Montvale, NJ 07645
Phone (201) 746-6577

817 Chestnut Ridge Rd
Chestnut Ridge, NY 10977
Phone (845) 352-7166

80 5th Ave
Rm 1205
New York, NY 10011
Phone (212) 924-2121

Organizations & group practices 3

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": "1629763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629763200000",
    "number": "1154098549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 CHESTNUT RIDGE RD",
            "city": "CHESTNUT RIDGE",
            "state": "NY",
            "postal_code": "109776314",
            "telephone_number": "845-352-7166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 5TH AVE RM 1205",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100118016",
            "telephone_number": "212-924-2121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "817 Chestnut Ridge Rd",
            "address_purpose": "LOCATION",
            "city": "Chestnut Ridge",
            "state": "NY",
            "postal_code": "109776314",
            "country_code": "US",
            "telephone_number": "845-352-7166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VALLEJO",
        "first_name": "DEANNA",
        "middle_name": "MERCEDES",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-24",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "013500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 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.