Individual provider Active NPI

Ted L Sazdanoff, D.C.

  • Chiropractor
  • Mansfield, OH
National Provider Identifier
1356472815
Registry record updated Jan 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
980 Issued in OH
Practice address
990 Lexington Ave
Mansfield, OH 44907-2246
Phone
(419) 756-6111
Fax
(419) 756-2549
NPI assigned
Mar 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 980 OH Primary

Addresses

Primary practice location

990 Lexington Ave
Mansfield, OH 44907-2246

Mailing address

990 Lexington Ave
Mansfield, OH 44907-2246
Phone (419) 756-6111

Other identifiers 2

IdentifierTypeStateIssuer
2765217MedicaidOH
341444686OtherOHTAX IDENTIFICATION

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040611000704 OH Practitioner - Chiropractic 8325021371 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
T L Sazdanoff DC IncGroup PAC ID 3375526312, 4 clinicians

Practice addresses (Care Compare)

990 Lexington Ave
Mansfield, OH 44907-2246
Phone (419) 756-6111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
980OHMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
T L Sazdanoff DC Inc Chiropractor CurrentSince Jun 1, 1983 Accepting new patients

Locations

990 Lexington Ave
Mansfield, OH 44907
Phone (419) 756-6111

Organizations & group practices 1

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": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357776000000",
    "number": "1356472815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 LEXINGTON AVE",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449072246",
            "telephone_number": "419-756-6111",
            "fax_number": "419-756-2549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 LEXINGTON AVE",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449072246",
            "telephone_number": "419-756-6111",
            "fax_number": "419-756-2549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAZDANOFF",
        "first_name": "TED",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-08",
        "last_updated": "2013-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "980",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2765217",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX IDENTIFICATION",
            "identifier": "341444686",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2013; 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.

Verify at the official NPI Registry.