Individual provider Active NPI

Joseph Tannous, D.C.

  • Chiropractor
  • San Mateo, CA
National Provider Identifier
1164502498
Registry record updated Nov 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC28543 Issued in CA
Practice address
100 S Ellsworth Ave Ste 804
San Mateo, CA 94401-3926
Phone
(650) 340-0045
Fax
(650) 340-0046
NPI assigned
Oct 17, 2006
Last updated
Nov 17, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC28543 CA Primary

Addresses

Primary practice location

100 S Ellsworth Ave Ste 804
San Mateo, CA 94401-3926

Mailing address

100 S Ellsworth Ave Ste 804
San Mateo, CA 94401-3926
Phone (650) 340-0045

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL N/A

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040902000652 CA Practitioner - Chiropractic 7214903145 Practice locations: San Mateo, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

100 S Ellsworth Ave
Suite 804
San Mateo, CA 94401-3926
Phone (650) 340-0045

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28543CAMDBehavioral Analyst
DC28543CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Okai Chiropractic Corporation Chiropractor PastSince Nov 20, 2022 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668643200000",
    "number": "1164502498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 S ELLSWORTH AVE STE 804",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944013926",
            "telephone_number": "650-340-0045",
            "fax_number": "650-340-0046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S ELLSWORTH AVE STE 804",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944013926",
            "telephone_number": "650-340-0045",
            "fax_number": "650-340-0046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNOUS",
        "first_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC28543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "N/A",
            "affiliation": "N",
            "address_1": "100 S Ellsworth Ave Ste 804",
            "city": "San Mateo",
            "state": "CA",
            "country_code": "US",
            "postal_code": "944013926",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2022; 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.