Individual provider Active NPI

Daniel T Dicesaro, DC

  • Chiropractor
  • Coraopolis, PA
National Provider Identifier
1275645335
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC007018L Issued in PA
Practice address
925 Brodhead Rd
Coraopolis, PA 15108-2353
Phone
(412) 299-3824
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 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 DC007018L PA Primary

Addresses

Primary practice location

925 Brodhead Rd
Coraopolis, PA 15108-2353

Mailing address

PO Box 861
Coraopolis, PA 15108-0861
Phone (412) 299-3824

Other identifiers 1

IdentifierTypeStateIssuer
345882OtherPABLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070426000215 PA Practitioner - Chiropractic 7517063241 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC007018LPAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Dicesaro Spine & Sport LLC Chiropractor CurrentSince Dec 24, 2020 Accepting new patients

Locations

925 Brodhead Rd
Coraopolis, PA 15108
Phone (412) 299-3824

5990 University Blvd
Ste 19
Coraopolis, PA 15108
Phone (412) 299-3824

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275645335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 861",
            "city": "CORAOPOLIS",
            "state": "PA",
            "postal_code": "151080861",
            "telephone_number": "412-299-3824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 BRODHEAD RD",
            "city": "CORAOPOLIS",
            "state": "PA",
            "postal_code": "151082353",
            "telephone_number": "412-299-3824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICESARO",
        "first_name": "DANIEL",
        "middle_name": "T",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC007018L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "345882",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coraopolis, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.