Organization Active NPI

Peluso Chiropractic Center PA

  • Health Service Clinic/Center
  • Palm Harbor, FL
National Provider Identifier
1255476230
Registry record updated Sep 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
CH5006 Issued in FL
Legal business name
PELUSO CHIROPRACTIC CENTER PA
Practice address
36949 US Highway 19 N
Palm Harbor, FL 34684-1238
Phone
(727) 934-7602
Fax
(727) 934-7704
NPI assigned
Feb 20, 2007
Last updated
Sep 27, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2021

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

Authorized official

Name
Joshua Bly, D.C.
Title
President
Phone
(727) 934-7602

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X CH5006 FL Primary
Primary Care Clinic/Center 261QP2300X CH 5006 FL
Rehabilitation Clinic/Center 261QR0400X CH 5006 FL

Addresses

Primary practice location

36949 US Highway 19 N
Palm Harbor, FL 34684-1238

Mailing address

36949 US Highway 19 N
Palm Harbor, FL 34684-1238
Phone (727) 934-7602

Other identifiers 1

IdentifierTypeStateIssuer
0554294-00MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111010000186 FL Part B Supplier - Clinic/Group Practice 2466624739 Receives reassigned benefits from 2 practitioners
Practice locations: Palm Harbor, FL

National Provider Directory

National Provider Directory

Locations

36949 US Highway 19 N
Palm Harbor, FL 34684
Phone (352) 799-3433

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632700800000",
    "number": "1255476230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36949 US HIGHWAY 19 N",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346841238",
            "telephone_number": "727-934-7602",
            "fax_number": "727-934-7704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36949 US HIGHWAY 19 N",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346841238",
            "telephone_number": "727-934-7602",
            "fax_number": "727-934-7704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PELUSO CHIROPRACTIC CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A",
        "authorized_official_last_name": "BLY",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "727-934-7602",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "FL",
            "license": "CH5006",
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "FL",
            "license": "CH 5006",
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "FL",
            "license": "CH 5006",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0554294-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Harbor, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.