Individual provider Active NPI

Konstantinos George Sofos, DC

  • Chiropractor
  • White Plains, NY
National Provider Identifier
1285792499
Registry record updated Aug 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X011312 Issued in NY
Practice address
235 Mamaroneck Ave
105
White Plains, NY 10605-1315
Phone
(914) 686-8844
Fax
(914) 686-8842
NPI assigned
Dec 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X011312 NY Primary

Addresses

Primary practice location

235 Mamaroneck Ave
105
White Plains, NY 10605-1315

Mailing address

235 Mamaroneck Ave
105
White Plains, NY 10605-1315
Phone (914) 686-8844

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080925000221 NY Practitioner - Chiropractic 5496720534 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 2000
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

235 Mamaroneck Ave
Suite 105
White Plains, NY 10605-1317
Phone (914) 686-8844

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
X011312NYMDChiropractor
27536CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
KGS Chiropractic PLLC Chiropractor CurrentSince Apr 2, 2018 Accepting new patients
Gleneida Medical Care PC Past Accepting new patients

Locations

235 Mamaroneck Ave
Ste 105
White Plains, NY 10605
Phone (914) 686-8844

Organizations & group practices 2

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": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439856000000",
    "number": "1285792499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 MAMARONECK AVE",
            "address_2": "105",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106051315",
            "telephone_number": "914-686-8844",
            "fax_number": "914-686-8842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 MAMARONECK AVE",
            "address_2": "105",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106051315",
            "telephone_number": "914-686-8844",
            "fax_number": "914-686-8842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOFOS",
        "first_name": "KONSTANTINOS",
        "middle_name": "GEORGE",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2015-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X011312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Plains, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2015; 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.

Verify at the official NPI Registry.