Individual provider Active NPI

Bert J Vanderbliek, DC

  • Chiropractor
  • Reseda, CA
National Provider Identifier
1245240100
Registry record updated Nov 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC18989 Issued in CA
Practice address
7439 Reseda Blvd
Reseda, CA 91335
Phone
(818) 345-4924
Fax
(818) 345-5529
NPI assigned
Aug 9, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC18989 CA Primary

Addresses

Primary practice location

7439 Reseda Blvd
Reseda, CA 91335

Mailing address

7439 Reseda Blvd
Reseda, CA 91335
Phone (818) 345-4924

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080508000272 CA Practitioner - Chiropractic 7719066240 Practice locations: Reseda, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Los Angeles College of Chiropractic, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7439 Reseda Blvd
Reseda, CA 91335-2819
Phone (818) 345-4924

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC18989CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Bert Vanderbliek DC Chiropractor PastSince Jan 1, 1990 Accepting new patients

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": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194912000000",
    "number": "1245240100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7439 RESEDA BLVD",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "91335",
            "telephone_number": "818-345-4924",
            "fax_number": "818-345-5529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7439 RESEDA BLVD",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "91335",
            "telephone_number": "818-345-4924",
            "fax_number": "818-345-5529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERBLIEK",
        "first_name": "BERT",
        "middle_name": "J",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2007-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC18989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reseda, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2007; 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.