Individual provider Active NPI

Jose J Mauricio, D.C.

  • Chiropractor
  • Orlando, FL
National Provider Identifier
1356401525
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH2735 Issued in FL
Practice address
4747 S Conway Rd
Orlando, FL 32812-1245
Phone
(407) 240-8430
Fax
(407) 438-8905
NPI assigned
Dec 11, 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 CH2735 FL Primary

Addresses

Primary practice location

4747 S Conway Rd
Orlando, FL 32812-1245

Mailing address

4747 S Conway Rd
Orlando, FL 32812-1245
Phone (407) 240-8430

Other identifiers 4

IdentifierTypeStateIssuer
5169160OtherFLAETNA
173908OtherFLCHIRO ALLIANCE CORP
8369250OtherFLCIGNA
229026OtherFLAMERIGROUP

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

LicenseStateTypeSpecialty
CH2735FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Mauricio Chiropractic Group Inc Chiropractor PastSince May 8, 2016 Accepting new patients
Mauricio Chiropractic North LLC Chiropractor PastSince Nov 20, 2004 Accepting new patients
Mauricio Chiropractic West LLC Chiropractor PastSince Apr 30, 2003 Accepting new patients
Mauricio Chiropractic South L L C Chiropractor PastSince Apr 30, 2003 Accepting new patients

Networks

  • Freedom Health HMO Network

Organizations & group practices 4

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": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356401525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4747 S CONWAY RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328121245",
            "telephone_number": "407-240-8430",
            "fax_number": "407-438-8905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4747 S CONWAY RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328121245",
            "telephone_number": "407-240-8430",
            "fax_number": "407-438-8905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAURICIO",
        "first_name": "JOSE",
        "middle_name": "J",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH2735",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5169160",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIRO ALLIANCE CORP",
            "identifier": "173908",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "8369250",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "229026",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

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.

Verify at the official NPI Registry.