Active NPI
Mitchell Ray Corwin, D.C.
- Internist Chiropractor
- Berkeley, CA
National Provider Identifier
1306900121
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internist Chiropractor
- License
- DC12144
- Practice address
- 2914 Domingo Ave
Suite B
Berkeley, CA 94705-2454 - Phone
- (510) 845-3246
- Fax
- (925) 962-9927
- NPI assigned
- Dec 20, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internist Chiropractor | 111NI0900X | DC12144 | CA | Primary |
Addresses
Primary practice location
2914 Domingo Ave
Suite B
Berkeley, CA 94705-2454
Mailing address
2914 Domingo Ave
Suite B
Berkeley, CA 94705-2454
Phone (510) 845-3246
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120626000530 | CA | Practitioner - Chiropractic | 8224293295 | Practice locations: Berkeley, CA; Pleasant Hill, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- New York Chiropractic College, 1977
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
2914 Domingo Ave
Berkeley, CA 94705-2454
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC12144 | CA | MD | Internist Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166572800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1306900121",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2914 DOMINGO AVE",
"address_2": "SUITE B",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947052454",
"telephone_number": "510-845-3246",
"fax_number": "925-962-9927"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2914 DOMINGO AVE",
"address_2": "SUITE B",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947052454",
"telephone_number": "510-845-3246",
"fax_number": "925-962-9927"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORWIN",
"first_name": "MITCHELL",
"middle_name": "RAY",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111NI0900X",
"taxonomy_group": "",
"desc": "Chiropractor, Internist",
"state": "CA",
"license": "DC12144",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Berkeley, CA
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.