Individual provider Active NPI

John Donald Rawa Jr., DC

  • Rehabilitation Chiropractor
  • Girard, PA
National Provider Identifier
1184601395
Registry record updated Jul 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
DC006470L Issued in PA
Practice address
4880 Birchdale Dr
Girard, PA 16417-1822
Phone
(814) 774-1400
Fax
(814) 774-3708
NPI assigned
Dec 29, 2005
Last updated
Jul 21, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Chiropractor 111NR0400X DC006470L PA Primary

Addresses

Primary practice location

4880 Birchdale Dr
Girard, PA 16417-1822

Mailing address

4880 Birchdale Dr
Girard, PA 16417-1822
Phone (814) 774-1400

Other identifiers 2

IdentifierTypeStateIssuer
G1807058OtherPABLUE CROSS
0017811730001MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101207000637 PA Practitioner - Chiropractic 8022205798 Practice locations: Girard, PA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4880 Birchdale Dr
Girard, PA 16417-1852
Phone (814) 774-1400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Charles F. Pados, DC PastSince Mar 15, 2018 Accepting new patients
Girard Family Chiropractic Rehabilitation PastSince Sep 18, 1996 Accepting new patients

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, 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": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311206400000",
    "number": "1184601395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4880 BIRCHDALE DR",
            "city": "GIRARD",
            "state": "PA",
            "postal_code": "164171822",
            "telephone_number": "814-774-1400",
            "fax_number": "814-774-3708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4880 BIRCHDALE DR",
            "city": "GIRARD",
            "state": "PA",
            "postal_code": "164171822",
            "telephone_number": "814-774-1400",
            "fax_number": "814-774-3708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAWA",
        "first_name": "JOHN",
        "middle_name": "DONALD",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-29",
        "last_updated": "2011-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "PA",
            "license": "DC006470L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "G1807058",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017811730001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Girard, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2011; 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.