Individual provider Active NPI

Michael A Palermo, DC

  • Chiropractor
  • Hazleton, PA
National Provider Identifier
1295727451
Registry record updated Jun 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC002759L Issued in PA
Practice address
1730 E Broad St
Hazleton, PA 18201-5657
Phone
(570) 497-4150
Fax
(570) 497-4151
NPI assigned
Aug 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC002759L PA Primary

Addresses

Primary practice location

1730 E Broad St
Hazleton, PA 18201-5657

Mailing address

1730 E Broad St
Hazleton, PA 18201-5657
Phone (570) 497-4150

Other identifiers 1

IdentifierTypeStateIssuer
0974175MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110621000643 PA Practitioner - Chiropractic 7719165794 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sacco Chiropractic PC Chiropractor CurrentSince Apr 23, 2024 Accepting new patients
Palermo Chiropractic Center Chiropractor PastSince Dec 20, 2010 Accepting new patients

Locations

1730 E Broad St
Hazleton, PA 18201
Phone (570) 455-3656

1730 E Broad St
Ste 1
Hazleton, PA 18201
Phone (570) 459-2226

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": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1295727451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1730 E BROAD ST",
            "city": "HAZLETON",
            "state": "PA",
            "postal_code": "182015657",
            "telephone_number": "570-497-4150",
            "fax_number": "570-497-4151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 E BROAD ST",
            "city": "HAZLETON",
            "state": "PA",
            "postal_code": "182015657",
            "telephone_number": "570-497-4150",
            "fax_number": "570-497-4151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALERMO",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC002759L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0974175",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazleton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2024; 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.