Individual provider Active NPI

Ronald J Manteuffel, D.C.

  • Chiropractor
  • Center Line, MI
National Provider Identifier
1295764041
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301004419 Issued in MI
Practice address
26672 Van Dyke Ave
Center Line, MI 48015-1222
Phone
(586) 716-8485
Fax
(586) 756-8279
NPI assigned
Jul 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301004419 MI Primary

Addresses

Primary practice location

26672 Van Dyke Ave
Center Line, MI 48015-1222

Mailing address

26672 Van Dyke Ave
Center Line, MI 48015-1222
Phone (586) 716-8485

Other identifiers 1

IdentifierTypeStateIssuer
1983052MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101216000805 MI Practitioner - Chiropractic 6406044569 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centerline Chiropractic Life Center PCGroup PAC ID 6608064704, 3 clinicians

Practice addresses (Care Compare)

28880 24 Mile Rd
Chesterfield, MI 48051-1605
Phone (586) 756-7671

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2301004419MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Centerline Chiropractic Life Center PC Chiropractor CurrentSince Feb 25, 1994 Accepting new patients

Locations

26672 Van Dyke Ave
Center Line, MI 48015
Phone (586) 716-8485

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": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295764041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26672 VAN DYKE AVE",
            "city": "CENTER LINE",
            "state": "MI",
            "postal_code": "480151222",
            "telephone_number": "586-716-8485",
            "fax_number": "586-756-8279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26672 VAN DYKE AVE",
            "city": "CENTER LINE",
            "state": "MI",
            "postal_code": "480151222",
            "telephone_number": "586-716-8485",
            "fax_number": "586-756-8279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANTEUFFEL",
        "first_name": "RONALD",
        "middle_name": "J",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301004419",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1983052",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Center Line, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.