Active NPI
Mary Ann Colarusso, D.C.
- Chiropractor
- Orchard Park, NY
National Provider Identifier
1215019674
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- X007452-1
- Practice address
- 3671 Southwestern Blvd
Suite 213
Orchard Park, NY 14127-1752 - Phone
- (716) 662-0900
- NPI assigned
- Oct 19, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | X007452-1 | NY | Primary |
Addresses
Primary practice location
3671 Southwestern Blvd
Suite 213
Orchard Park, NY 14127-1752
Mailing address
3075 Southwestern Blvd
Suite 208
Orchard Park, NY 14127-1749
Phone (716) 662-0900
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007452 | NY | MD | Mental Health Counselor |
| X007452-1 | NY | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1441756800000",
"number": "1215019674",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3075 SOUTHWESTERN BLVD",
"address_2": "SUITE 208",
"city": "ORCHARD PARK",
"state": "NY",
"postal_code": "141271749",
"telephone_number": "716-662-0900",
"fax_number": "716-740-8059"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3671 SOUTHWESTERN BLVD",
"address_2": "SUITE 213",
"city": "ORCHARD PARK",
"state": "NY",
"postal_code": "141271752",
"telephone_number": "716-662-0900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLARUSSO",
"first_name": "MARY ANN",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-19",
"last_updated": "2015-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NY",
"license": "X007452-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orchard Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.