Individual provider Active NPI

Justin Alexis Sujo, DC

  • Chiropractor
  • Miami, FL
National Provider Identifier
1295313542
Registry record updated Mar 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH13312 Issued in FL
Practice address
13710 SW 84TH St
Miami, FL 33183-4040
Phone
(305) 385-7200
NPI assigned
Mar 30, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH13312 FL Primary

Addresses

Primary practice location

13710 SW 84TH St
Miami, FL 33183-4040

Mailing address

5645 SW 163Rd Path
Miami, FL 33193-5643
Phone (305) 926-7898

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL https://fisherchiropracticcenter.com/

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220922001141 FL Practitioner - Chiropractic 3577948066 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vital Spine and Health Studio LLCGroup PAC ID 5496130981, 2 clinicians

Practice addresses (Care Compare)

12484 SW 127TH Ave
Miami, FL 33186-6597
Phone (786) 701-8353

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Vital Spine and Health Studio, LLC Chiropractor CurrentSince Jul 21, 2022 Accepting new patients

Locations

12484 SW 127th Ave
Miami, FL 33186
Phone (305) 252-7773

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": "1617062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1295313542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5645 SW 163RD PATH",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331935643",
            "telephone_number": "305-926-7898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13710 SW 84TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331834040",
            "telephone_number": "305-385-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUJO",
        "first_name": "JUSTIN",
        "middle_name": "ALEXIS",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-30",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH13312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://fisherchiropracticcenter.com/",
            "affiliation": "N",
            "address_1": "13710 SW 84th St",
            "city": "Miami",
            "state": "FL",
            "country_code": "US",
            "postal_code": "331834040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2021; 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.