Individual provider Active NPI

Timothy J. Manchin, D.C.

  • Chiropractor
  • Westlake Village, CA
National Provider Identifier
1164594578
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC25750 Issued in CA
Practice address
790 Hampshire Rd Ste E
Westlake Village, CA 91361-5933
Phone
(805) 277-4951
Fax
(805) 813-8142
NPI assigned
Nov 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 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 DC25750 CA Primary

Addresses

Primary practice location

790 Hampshire Rd Ste E
Westlake Village, CA 91361-5933

Mailing address

3548 Hearst Dr
Simi Valley, CA 93063-3237
Phone (310) 579-5799

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040325001783 CA Practitioner - Chiropractic 6002708906 Practice locations: Westlake Village, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1996
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

790 Hampshire Rd
Suite E
Westlake Village, CA 91361-5933
Phone (310) 579-5799

790 Hampshire Rd E
Westlake Village, CA 91361-2606

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25750CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Simi Valley Therapies West, Inc. PastSince Oct 14, 2016 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1164594578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3548 HEARST DR",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930633237",
            "telephone_number": "310-579-5799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 HAMPSHIRE RD STE E",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913615933",
            "telephone_number": "805-277-4951",
            "fax_number": "805-813-8142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANCHIN",
        "first_name": "TIMOTHY",
        "middle_name": "J.",
        "name_prefix": "Mr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC25750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westlake Village, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.