Individual provider Active NPI

Michael James Snyder, D.C.

  • Chiropractor
  • Newport Beach, CA
National Provider Identifier
1174615207
Registry record updated Jul 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC22930 Issued in CA
Practice address
1601 Dove St
Ste 170
Newport Beach, CA 92660-1421
Phone
(949) 229-5297
Fax
(815) 425-4215
NPI assigned
Sep 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC22930 CA Primary

Addresses

Primary practice location

1601 Dove St
Ste 170
Newport Beach, CA 92660-1421

Mailing address

1601 Dove St
Ste 170
Newport Beach, CA 92660-1421
Phone (949) 229-5297

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051102000307 CA Practitioner - Chiropractic 9032136601 Reassigns benefits to 1 organization
Practice locations: Newport Beach, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22930CAMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Interventional Pain Medical Group CurrentSince Dec 1, 2015 Accepting new patients
Michael J. Snyder, D.C. Chiropractor PastSince Apr 23, 2012 Accepting new patients

Locations

1601 Dove St
Ste 170
Newport Beach, CA 92660
Phone (949) 467-9081

14120 Alondra Blvd
Ste C
Santa Fe Springs, CA 90670

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": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468972800000",
    "number": "1174615207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 DOVE ST",
            "address_2": "STE 170",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926601421",
            "telephone_number": "949-229-5297",
            "fax_number": "815-425-4215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 DOVE ST",
            "address_2": "STE 170",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926601421",
            "telephone_number": "949-229-5297",
            "fax_number": "815-425-4215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNYDER",
        "first_name": "MICHAEL",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2016-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC22930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.