Individual provider Active NPI

Sean Clancy, DC

  • Chiropractor
  • New York, NY
National Provider Identifier
1215337191
Registry record updated Jun 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X012542-1 Issued in NY
Practice address
133 E 58TH St
New York, NY 10022-1236
Phone
(212) 371-2000
Fax
(212) 371-2250
NPI assigned
Aug 28, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X012542-1 NY Primary

Addresses

Primary practice location

133 E 58TH St
New York, NY 10022-1236

Mailing address

1941 Deer Park Ave
Ste a
Deer Park, NY 11729-3326
Phone (631) 254-0155

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140919000236 NY Practitioner - Chiropractic 8022237346 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dr David Ackerman DC PCGroup PAC ID 0941429013, 4 clinicians

Practice addresses (Care Compare)

6080 Jericho Tpke
Suite 305
Commack, NY 11725-2808
Phone (631) 499-6180

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X012542-1NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. David Ackerman DC PC Chiropractor CurrentSince Mar 1, 2023 Accepting new patients

Locations

6080 Jericho Tpke
Ste 305
Commack, NY 11725
Phone (631) 499-6180

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": "1409184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561334400000",
    "number": "1215337191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1941 DEER PARK AVE",
            "address_2": "STE A",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117293326",
            "telephone_number": "631-254-0155",
            "fax_number": "631-254-0157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 E 58TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100221236",
            "telephone_number": "212-371-2000",
            "fax_number": "212-371-2250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLANCY",
        "first_name": "SEAN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-28",
        "last_updated": "2019-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X012542-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2019; 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.