Individual provider Active NPI

Maria N Cutler, D.O.

  • Chiropractor
  • Santa Rosa, CA
National Provider Identifier
1295036713
Registry record updated Nov 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC25503 Issued in CA
Practice address
2323 Bethards Dr
Santa Rosa, CA 95405-8500
Phone
(707) 576-7000
Fax
(707) 576-0656
NPI assigned
Nov 15, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC25503 CA Primary

Addresses

Primary practice location

2323 Bethards Dr
Santa Rosa, CA 95405-8500

Mailing address

2323 Bethards Dr
Santa Rosa, CA 95405-8500
Phone (707) 576-7000

Other identifiers 1

IdentifierTypeStateIssuer
DC25503OtherCASTATE LICENSE #

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170110002105 CA Practitioner - Chiropractic 6204117070 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DC25503CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Synergy Medical Group a Professional Corporation Chiropractor CurrentSince Dec 4, 2016 Accepting new patients
Providence Medical Foundation Past Accepting new patients

Locations

4655 Hoen Ave
Ste 4
Santa Rosa, CA 95405
Phone (707) 546-2057

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": "1289779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289779200000",
    "number": "1295036713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2323 BETHARDS DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954058500",
            "telephone_number": "707-576-7000",
            "fax_number": "707-576-0656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2323 BETHARDS DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954058500",
            "telephone_number": "707-576-7000",
            "fax_number": "707-576-0656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUTLER",
        "first_name": "MARIA",
        "middle_name": "N",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-15",
        "last_updated": "2010-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC25503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE #",
            "identifier": "DC25503",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2010; 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.