Individual provider Active NPI

Vince Disaia, D.C.

  • Chiropractor
  • Lake Forest, CA
National Provider Identifier
1154514636
Registry record updated Apr 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
30492 Issued in CA
Practice address
22661 Lambert St
Suite 207
Lake Forest, CA 92630-1612
Phone
(949) 916-9742
Fax
(949) 716-2694
NPI assigned
Aug 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 30492 CA Primary

Addresses

Primary practice location

22661 Lambert St
Suite 207
Lake Forest, CA 92630-1612

Mailing address

22661 Lambert St
Suite 207
Lake Forest, CA 92630-1612
Phone (949) 916-9742

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140331002145 CA Practitioner - Chiropractic 7719118934 Reassigns benefits to 1 organization
Practice locations: Lake Forest, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2006
Medicare assignment
May accept Medicare assignment
Group practices
Dr. Christian Barney, D.C. Chiropractic CorpGroup PAC ID 0244470920, 2 clinicians

Practice addresses (Care Compare)

2737 Campus Dr
Irvine, CA 92612-1602
Phone (949) 476-1250

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30492CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Christian Barney, D.C. Chiropractic Corp Chiropractor CurrentSince Apr 29, 2021 Accepting new patients
Restor Physical Therapy Inc. Past Accepting new patients

Locations

2737 Campus Dr
Irvine, CA 92612
Phone (714) 754-7268

Organizations & group practices 2

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": "1187568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335484800000",
    "number": "1154514636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22661 LAMBERT ST",
            "address_2": "SUITE 207",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926301612",
            "telephone_number": "949-916-9742",
            "fax_number": "949-716-2694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22661 LAMBERT ST",
            "address_2": "SUITE 207",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926301612",
            "telephone_number": "949-916-9742",
            "fax_number": "949-716-2694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISAIA",
        "first_name": "VINCE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-20",
        "last_updated": "2012-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "30492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Forest, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2012; 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.