Individual provider Active NPI

Carolyn Jane Lukonaitis, DC

  • Chiropractor
  • Silver Creek, NY
National Provider Identifier
1164506853
Registry record updated Sep 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X0105280B Issued in NY
Practice address
194 Central Ave
Silver Creek, NY 14136-1338
Phone
(716) 934-7772
Fax
(716) 934-4971
NPI assigned
Oct 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 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 X0105280B NY Primary

Addresses

Primary practice location

194 Central Ave
Silver Creek, NY 14136-1338

Mailing address

194 Central Ave
Silver Creek, NY 14136-1338
Phone (716) 934-7772

Other identifiers 2

IdentifierTypeStateIssuer
693171OtherNYEMPIRE MPN
8812992OtherNYINDENDENT HEALTH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051117000585 NY Practitioner - Chiropractic 9032138102 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

39 Main St
Silver Creek, NY 14136-1416
Phone (716) 934-7772

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X0105280BNYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Silver Creek Chiropractic PC Chiropractor CurrentSince May 23, 2012 Accepting new patients
Forestville Chiropractic PC Chiropractor Past Accepting new patients
Bova Family Chiropractic Chiropractor PastSince Oct 6, 2003 Accepting new patients
Forestville Chiropractic PC Chiropractor PastSince Jul 15, 2018 Accepting new patients

Locations

39 Main St
Silver Creek, NY 14136
Phone (716) 432-3898

Organizations & group practices 4

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": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189728000000",
    "number": "1164506853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "194 CENTRAL AVE",
            "city": "SILVER CREEK",
            "state": "NY",
            "postal_code": "141361338",
            "telephone_number": "716-934-7772",
            "fax_number": "716-934-4971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "194 CENTRAL AVE",
            "city": "SILVER CREEK",
            "state": "NY",
            "postal_code": "141361338",
            "telephone_number": "716-934-7772",
            "fax_number": "716-934-4971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUKONAITIS",
        "first_name": "CAROLYN",
        "middle_name": "JANE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2007-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X0105280B",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE MPN",
            "identifier": "693171",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDENDENT HEALTH",
            "identifier": "8812992",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver Creek, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.