Individual provider Active NPI

Mark Mossuto, D.C.

  • Chiropractor
  • San Diego, CA
National Provider Identifier
1285790212
Registry record updated Feb 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC23070 Issued in CA
Practice address
7540 Metropolitan Dr
Suite 109
San Diego, CA 92108-4499
Phone
(619) 294-9342
Fax
(619) 294-9365
NPI assigned
Dec 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC23070 CA Primary

Addresses

Primary practice location

7540 Metropolitan Dr
Suite 109
San Diego, CA 92108-4499

Mailing address

7540 Metropolitan Dr
Suite 109
San Diego, CA 92108-4499
Phone (619) 294-9342

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080416000331 CA Practitioner - Chiropractic 7911085931 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC23070CAMDChiropractor
23070CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mossuto Chiropractic Corporation Chiropractor CurrentSince May 26, 2018 Accepting new patients

Locations

7540 Metropolitan Dr
Ste 109
San Diego, CA 92108
Phone (619) 261-7415

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": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203897600000",
    "number": "1285790212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7540 METROPOLITAN DR",
            "address_2": "SUITE 109",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921084499",
            "telephone_number": "619-294-9342",
            "fax_number": "619-294-9365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7540 METROPOLITAN DR",
            "address_2": "SUITE 109",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921084499",
            "telephone_number": "619-294-9342",
            "fax_number": "619-294-9365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSSUTO",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2008-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC23070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2008; 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.