John Mark Mistretta, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

X005973-1 Issued in NY

Practice address

6 McMaster St Ste 1
Owego, NY 13827-1029

Phone

(607) 687-2242

Fax

(607) 687-9128

NPI assigned

Oct 3, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Tier Chiropractic Offices

  • Chiropractor
  • Owego, NY
  • NPI 1659518777
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346335668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 MCMASTER ST STE 1",
            "city": "OWEGO",
            "state": "NY",
            "postal_code": "138271029",
            "telephone_number": "607-687-2242",
            "fax_number": "607-687-9128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 MCMASTER ST STE 1",
            "city": "OWEGO",
            "state": "NY",
            "postal_code": "138271029",
            "telephone_number": "607-687-2242",
            "fax_number": "607-687-9128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISTRETTA",
        "first_name": "JOHN",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X005973-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EXCELLUS BC/BS",
            "identifier": "000129776",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christina A. Menichello, NCC
• Katherine Mary Mikulski, LMSW LP
• Melanie Miller
• Raymond Joseph Mint, OD
• Sarah Christine Misson, LMT
• Ruth A Mitchell, LMSW
• Porshea Linnette Moore, CRPA
• Michele Smith Morey, LPNN
• Heather Morgan
• Lori A Morgan, LCSW-R

• Chiropractor in Owego, NY
• Providers in Owego, NY by specialty
• Chiropractor in New York

• 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.

Verify at the official NPI Registry.