Individual provider Active NPI

Anthony Viscusi, DC

  • Chiropractor
  • Lake Worth, FL
National Provider Identifier
1154435667
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH6501 Issued in FL
Practice address
5804 Jog Rd
Lake Worth, FL 33467-6511
Phone
(561) 967-7440
Fax
(561) 967-9987
NPI assigned
Aug 19, 2006
Sex
Male
Sole proprietor
Yes

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 CH6501 FL Primary

Addresses

Primary practice location

5804 Jog Rd
Lake Worth, FL 33467-6511

Mailing address

5804 Jog Rd
Lake Worth, FL 33467-6511
Phone (561) 967-7440

Other identifiers 1

IdentifierTypeStateIssuer
380250700MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120221000085 FL Practitioner - Chiropractic 1759549819 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5804 Jog Rd
Lake Worth, FL 33467
Phone (561) 967-7440

5804 S Jog Rd
Lake Worth, FL 33467-6511

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH6501FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Anthony Viscusi, DC,PA Chiropractor CurrentSince Sep 24, 2011 Accepting new patients

Locations

5804 S Jog Rd
Lake Worth, FL 33467
Phone (561) 966-6033

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": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154435667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5804 JOG RD",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334676511",
            "telephone_number": "561-967-7440",
            "fax_number": "561-967-9987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5804 JOG RD",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334676511",
            "telephone_number": "561-967-7440",
            "fax_number": "561-967-9987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VISCUSI",
        "first_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH6501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "380250700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Worth, FL

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.