Individual provider Active NPI

Yaniv J Dvora, D.C.

  • Chiropractor
  • Simi Valley, CA
National Provider Identifier
1225116775
Registry record updated Apr 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC 27909 Issued in CA
Practice address
2072 Tapo St
Simi Valley, CA 93063-3441
Phone
(805) 584-1114
Fax
(805) 584-3102
NPI assigned
Nov 1, 2006
Last updated
Apr 17, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC 27909 CA Primary

Addresses

Primary practice location

2072 Tapo St
Simi Valley, CA 93063-3441

Mailing address

2072 Tapo St
Simi Valley, CA 93063-3441
Phone (805) 584-1114

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050813000162 CA Practitioner - Chiropractic 1153350780 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2072 Tapo St
Simi Valley, CA 93063-3441
Phone (805) 584-1114

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC 27909CAMDChiropractor
27909CAMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Lloyd E. Boland, D.C., a Chiropractic Corporation Chiropractor PastSince May 2, 2012 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334620800000",
    "number": "1225116775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2072 TAPO ST",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930633441",
            "telephone_number": "805-584-1114",
            "fax_number": "805-584-3102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2072 TAPO ST",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930633441",
            "telephone_number": "805-584-1114",
            "fax_number": "805-584-3102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DVORA",
        "first_name": "YANIV",
        "middle_name": "J",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2012-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC 27909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Simi Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2012; 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.