Rose A Ducasse, DC
Individual provider Active NPI Chiropractor · Grants, NM
NPI 1336116458 · NPPES record last updated Jan 14, 2014
Key facts
- NPI
- 1336116458
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 1749 (NM)
- Practice address
- 601 N 1St St
Suite B
Grants, NM 87020-2703 - Phone
- (505) 287-5377
- Fax
- (505) 287-5508
- NPI assigned
- Mar 7, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Life Chiropractic College, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
601 N 1St St
B
Grants, NM 87020-2703
Phone (505) 287-5377
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090713000360 | NM | Practitioner - Chiropractic | 8729065255 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CH 8548 | FL | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ducasse Chiropractic Inc | Chiropractor | Current |
Accepting new patients |
| American Chiropractic & Rehabilitation LLC | Chiropractor | Past |
Accepting new patients |
Locations
7933 Baymeadows Way
Ste 7
Jacksonville, FL 32256
Phone (800) 733-7066
601 N First St
#B
Grants, NM 87020
Phone (505) 287-5377
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CH 8548 | FL | |
| Chiropractor | 111N00000X | 1749 | NM | Yes |
Addresses
Primary practice location
601 N 1St St
Suite B
Grants, NM 87020-2703
Mailing address
PO Box 540
Grants, NM 87020-0540
Phone (505) 287-5377
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 15051587 | Medicaid | NM |
Other providers in Grants, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 14, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.