Individual provider Active NPI

Edward Martin Frattini, DC

  • Chiropractor
  • Saint Clair Shores, MI
National Provider Identifier
1245227511
Registry record updated Nov 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301004723 Issued in MI
Practice address
22701 Greater Mack Ave
Saint Clair Shores, MI 48080-2007
Phone
(586) 777-6056
Fax
(585) 775-7246
NPI assigned
Oct 3, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301004723 MI Primary

Addresses

Primary practice location

22701 Greater Mack Ave
Saint Clair Shores, MI 48080-2007

Mailing address

22701 Greater Mack Ave
Saint Clair Shores, MI 48080-2007
Phone (586) 777-6056

Other identifiers 3

IdentifierTypeStateIssuer
141979434MedicaidMI
0E05199OtherMIBCBS
TR077OtherMIPPOM

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110120000145 MI Practitioner - Chiropractic 4789863986 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

22701 Greater Mack
Saint Clair Shores, MI 48080-2007

22701 Greater Mack Ave
Saint Clair Shores, MI 48080-2007
Phone (586) 777-6056

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2301004723MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Frattini Chiropractic Services PC Chiropractor CurrentSince Jan 31, 2011 Accepting new patients

Locations

22701 Greater Mack Ave
St Clr Shores, MI 48080
Phone (586) 777-6056

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": "1128297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291075200000",
    "number": "1245227511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22701 GREATER MACK AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480802007",
            "telephone_number": "586-777-6056",
            "fax_number": "585-775-7246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22701 GREATER MACK AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480802007",
            "telephone_number": "586-777-6056",
            "fax_number": "585-775-7246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRATTINI",
        "first_name": "EDWARD",
        "middle_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-03",
        "last_updated": "2010-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301004723",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "141979434",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0E05199",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PPOM",
            "identifier": "TR077",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2010; 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.