Individual provider Active NPI

Thomas Bateman Kinsella, D.C.

  • Chiropractor
  • Aurora, IL
National Provider Identifier
1205276102
Registry record updated Jul 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038012475 Issued in IL
Practice address
896 S Frontenac St Ste 100
Aurora, IL 60504-3164
Phone
(630) 800-2720
Fax
(855) 969-4331
NPI assigned
Jun 25, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 038012475 IL Primary

Addresses

Primary practice location

896 S Frontenac St Ste 100
Aurora, IL 60504-3164

Mailing address

22907 Weinhold Dr
Plainfield, IL 60585-4205
Phone (630) 854-3245

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131212000316 IL Practitioner - Chiropractic 5799929030 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2013
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

896 S Frontenac St
Suite 100
Aurora, IL 60504-3164
Phone (630) 800-2720

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sparc Chiropractic, P.C. Chiropractor CurrentSince Jul 1, 2013 Accepting new patients

Locations

896 S Frontenac St
Ste 100
Aurora, IL 60504
Phone (630) 800-2720

3504 Grand Blvd
Brookfield, IL 60513
Phone (708) 255-5053

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": "1372118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689724800000",
    "number": "1205276102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22907 WEINHOLD DR",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605854205",
            "telephone_number": "630-854-3245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "896 S FRONTENAC ST STE 100",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605043164",
            "telephone_number": "630-800-2720",
            "fax_number": "855-969-4331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINSELLA",
        "first_name": "THOMAS",
        "middle_name": "BATEMAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-25",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038012475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2023; 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.