Individual provider Active NPI

Daniel P Perry, D.C.

  • Chiropractor
  • Brockport, NY
National Provider Identifier
1205802873
Registry record updated May 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X007852-1 Issued in NY
Practice address
12 Liberty St
Brockport, NY 14420
Phone
(585) 637-5398
Fax
(585) 637-5398
NPI assigned
Feb 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X007852-1 NY Primary

Addresses

Primary practice location

12 Liberty St
Brockport, NY 14420

Mailing address

12 Liberty St
Brockport, NY 14420
Phone (585) 637-5398

Other identifiers 5

IdentifierTypeStateIssuer
P010007852OtherNYBC/BS, BC
16 1549292-01OtherNYPRISM
5595618OtherNYAETNA
C-07852-9OtherNYWORKERS COMP/NO-FAULT
007852OtherNYMISC INSURANCE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080606000614 NY Practitioner - Chiropractic 1052481744 Practice locations: Brockport, NY

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12 Liberty St
Brockport, NY 14420-1630
Phone (585) 637-5398

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
007852NYMDMental Health Counselor
X007852-1NYMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401321600000",
    "number": "1205802873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 LIBERTY ST",
            "city": "BROCKPORT",
            "state": "NY",
            "postal_code": "14420",
            "telephone_number": "585-637-5398",
            "fax_number": "585-637-5398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 LIBERTY ST",
            "city": "BROCKPORT",
            "state": "NY",
            "postal_code": "14420",
            "telephone_number": "585-637-5398",
            "fax_number": "585-637-5398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "DANIEL",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-24",
        "last_updated": "2014-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X007852-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS, BC",
            "identifier": "P010007852",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRISM",
            "identifier": "16 1549292-01",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5595618",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS COMP/NO-FAULT",
            "identifier": "C-07852-9",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISC INSURANCE",
            "identifier": "007852",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2014; 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.