Benjamin Thomas Andrulot, D.C.
Individual provider Active NPI Sports Physician Chiropractor · Orleans, MA
NPI 1245201649 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1245201649
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Sports Physician Chiropractor 111NS0005X
- License
- 2879 (MA)
- Practice address
- 47 Main St
Orleans, MA 02653-2424 - Phone
- (508) 240-7600
- Fax
- (508) 240-7686
- NPI assigned
- Feb 1, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- New York Chiropractic College, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
26 Court St
Provincetown, MA 02657-1322
Phone (508) 487-0704
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040429000169 | MA | Practitioner - Chiropractic | 1052308251 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2879 | MA | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Complete Care Chiropractic, Inc. | Current |
Accepting new patients | |
| At Ease Mental Health Inc | Past |
Accepting new patients |
Locations
47 Main St
Orleans, MA 02653
Phone (508) 240-7600
26 Court St
Ste 4
Provincetown, MA 02657
26 Court St
Provincetown, MA 02657
Phone (508) 444-9966
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Physician Chiropractor | 111NS0005X | 2879 | MA | Yes |
Addresses
Primary practice location
47 Main St
Orleans, MA 02653-2424
Mailing address
40 Blue Rock Rd
South Yarmouth, MA 02664-1333
Phone (508) 240-7600
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1600541 | Other | MA | MASSHEALTH |
| 7335964 | Other | MA | AETNA HEALTHCARE |
| 1660669 | Other | MA | CIGNA HEALTHCARE |
| Y37048 | Other | MA | BCBS OF MA |
| AA80633 | Other | MA | HARVARD PILGRIM HEALTH |
Other providers in Orleans, MA
- Akoya Behavioral & Complementary Health Care PLLC
- Ruth Anne Albanese
- Rebecca Aaron Alves
- Amy Burke LLC
- Annette Anderson
- Melanie Antone
- Arch Orthodontics
- Lisa Arnold
- Arthur F. Hannigan DMD PC
- Jennifer Gooch Avery
All providers in Orleans, MA · Sports Physician Chiropractor in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.