Individual provider Active NPI

Martin John Dipetta, D.C.

  • Chiropractor
  • Elmira, NY
National Provider Identifier
1194043919
Registry record updated May 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X011860-1 Issued in NY
Practice address
907 Pennsylvania Ave
Elmira, NY 14904-2633
Phone
(607) 738-6200
NPI assigned
May 5, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X011860-1 NY Primary

Addresses

Primary practice location

907 Pennsylvania Ave
Elmira, NY 14904-2633

Mailing address

80 Pine Hills Dr
Pine City, NY 14871-9005

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101116000470 NY Practitioner - Chiropractic 7810182854 Practice locations: Elmira, NY

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

907 Pennsylvania Ave
Elmira, NY 14904-2633
Phone (607) 767-6497

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
011860NYMDMental Health Counselor
X011860-1NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Dipetta Chiropractic Chiropractor CurrentSince Sep 13, 2010 Accepting new patients

Locations

907 Pennsylvania Ave
Elmira, NY 14904
Phone (607) 738-6200

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": "1273017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273017600000",
    "number": "1194043919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 PINE HILLS DR",
            "city": "PINE CITY",
            "state": "NY",
            "postal_code": "148719005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 PENNSYLVANIA AVE",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149042633",
            "telephone_number": "607-738-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIPETTA",
        "first_name": "MARTIN",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-05-05",
        "last_updated": "2010-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X011860-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmira, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2010; 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.