Active NPI
Ralph Anthony Criscuolo, DC CC SP
- Chiropractor
- North Haven, CT
National Provider Identifier
1316029424
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 000911
- Practice address
- 18 Broadway
North Haven, CT 06473-2301 - Phone
- (203) 234-7989
- Fax
- (203) 234-7516
- NPI assigned
- Oct 19, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 000911 | CT | Primary |
Addresses
Primary practice location
18 Broadway
North Haven, CT 06473-2301
Mailing address
18 Broadway
North Haven, CT 06473-2301
Phone (203) 234-7989
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0V9705 | Other | CT | HEALTHNET INS |
| P3641945 | Other | CT | OXFORD HEALTH INSURANCE |
| 050000911CT02 | Other | CT | BLUE CROSS INS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000911 | CT | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Omni Physical & Aquatic Therapy Center, Inc | Chiropractor | Past | Accepting new patients |
| Connecticut Chiropractic Specialists LLC | Chiropractor | Past | Accepting new patients |
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.
-
- Chiropractor
- Milford, CT
- NPI 1871619056
-
- Physical Medicine & Rehabilitation Physician
- Wallingford, CT
- NPI 1861537995
Chiropractor
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1316029424",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18 BROADWAY",
"city": "NORTH HAVEN",
"state": "CT",
"postal_code": "064732301",
"telephone_number": "203-234-7989",
"fax_number": "203-234-7516"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18 BROADWAY",
"city": "NORTH HAVEN",
"state": "CT",
"postal_code": "064732301",
"telephone_number": "203-234-7989",
"fax_number": "203-234-7516"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRISCUOLO",
"first_name": "RALPH",
"middle_name": "ANTHONY",
"name_prefix": "Dr.",
"credential": "DC CC SP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CT",
"license": "000911",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHNET INS",
"identifier": "0V9705",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD HEALTH INSURANCE",
"identifier": "P3641945",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS INS",
"identifier": "050000911CT02",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in North Haven, CT
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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.