Active NPI
Matthew John Demoss, D.C.
- Chiropractor
- Orange, CA
National Provider Identifier
1255458436
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC25316
- Practice address
- 1421 N Wanda Rd
Suite 160
Orange, CA 92867-5343 - Phone
- (714) 532-0999
- Fax
- (714) 532-0913
- NPI assigned
- Mar 23, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC25316 | CA | Primary |
Addresses
Primary practice location
1421 N Wanda Rd
Suite 160
Orange, CA 92867-5343
Mailing address
1421 N Wanda Rd
Suite 160
Orange, CA 92867-5343
Phone (714) 532-0999
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120131000079 | CA | Practitioner - Chiropractic | 3678730876 | Practice locations: Orange, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Los Angeles College of Chiropractic, 1997
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1421 N Wanda Rd
Suite 160
Orange, CA 92867-5300
Phone (714) 532-0999
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC25316 | CA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1404086400000",
"number": "1255458436",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1421 N WANDA RD",
"address_2": "SUITE 160",
"city": "ORANGE",
"state": "CA",
"postal_code": "928675343",
"telephone_number": "714-532-0999",
"fax_number": "714-532-0913"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1421 N WANDA RD",
"address_2": "SUITE 160",
"city": "ORANGE",
"state": "CA",
"postal_code": "928675343",
"telephone_number": "714-532-0999",
"fax_number": "714-532-0913"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEMOSS",
"first_name": "MATTHEW",
"middle_name": "JOHN",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-23",
"last_updated": "2014-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC25316",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Orange, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2014; 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.