Organization Active NPI

Iammatteo Family Chiropractic PLLC

  • Chiropractor
  • Warwick, NY
National Provider Identifier
1275880106
Registry record updated Jul 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X008087-1 Issued in NY
Legal business name
IAMMATTEO FAMILY CHIROPRACTIC PLLC
Practice address
9 Ronald Reagan Blvd
Warwick, NY 10990-4115
Phone
(845) 421-3997
NPI assigned
Aug 9, 2012
Last updated
Jul 18, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2018

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

Authorized official

Name
Dr. Laurene T. Iammatteo, D.C.NPI 1609963206
Title
Doctor of Chiropractic
Phone
(845) 421-3997

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X008087-1 NY Primary

Addresses

Primary practice location

9 Ronald Reagan Blvd
Warwick, NY 10990-4115

Mailing address

9 Ronald Reagan Blvd
Warwick, NY 10990-4115
Phone (845) 421-3997

Other identifiers 1

IdentifierTypeStateIssuer
01751091MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121114000208 NY Part B Supplier - Clinic/Group Practice 8123279494 Receives reassigned benefits from 1 practitioner
Practice locations: Chester, NY

National Provider Directory

National Provider Directory

Locations

1136 Kings Hwy
Ste 5
Chester, NY 10918
Phone (845) 421-3997

9 Ronald Reagan Blvd
Warwick, NY 10990
Phone (845) 986-6400

Practitioners & affiliated clinicians

Practitioners 1

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": "1344470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531872000000",
    "number": "1275880106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 RONALD REAGAN BLVD",
            "city": "WARWICK",
            "state": "NY",
            "postal_code": "109904115",
            "telephone_number": "845-421-3997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 RONALD REAGAN BLVD",
            "city": "WARWICK",
            "state": "NY",
            "postal_code": "109904115",
            "telephone_number": "845-421-3997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IAMMATTEO FAMILY CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-09",
        "last_updated": "2018-07-18",
        "status": "A",
        "authorized_official_last_name": "IAMMATTEO",
        "authorized_official_first_name": "LAURENE",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "DOCTOR OF CHIROPRACTIC",
        "authorized_official_telephone_number": "845-421-3997",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X008087-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01751091",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warwick, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2018; 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.