Individual provider Active NPI

Fuyuko Ikehara Oddy, D.C.

  • Chiropractor
  • Liverpool, NY
National Provider Identifier
1396823027
Registry record updated Sep 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
009967 Issued in NY
Practice address
8134 Oswego Rd
Liverpool, NY 13090
Phone
(315) 622-1500
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 009967 NY Primary

Addresses

Primary practice location

8134 Oswego Rd
Liverpool, NY 13090

Mailing address

8134 Oswego Rd
Liverpool, NY 13090-1500
Phone (315) 622-1500

Other identifiers 1

IdentifierTypeStateIssuer
RA6958OtherNYMEDICARE PTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040514000632 NY Practitioner - Chiropractic 6507856291 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8134 Oswego Rd
Liverpool, NY 13090-1500
Phone (315) 622-1500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
CMC Chiropractic, P.C. Chiropractor CurrentSince Jul 11, 2005 Accepting new patients

Locations

8134 Oswego Rd
Liverpool, NY 13090
Phone (315) 303-2082

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315267200000",
    "number": "1396823027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8134 OSWEGO RD",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130901500",
            "telephone_number": "315-622-1500",
            "fax_number": "315-622-4073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8134 OSWEGO RD",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "13090",
            "telephone_number": "315-622-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODDY",
        "first_name": "FUYUKO",
        "middle_name": "IKEHARA",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2011-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "009967",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "RA6958",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Liverpool, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2011; 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.