Individual provider Active NPI

Phillip Messineo, DC

  • Chiropractor
  • Cambridge, MA
National Provider Identifier
1407633217
Registry record updated Sep 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHI3834 Issued in MA
Practice address
777 Concord Ave Ste 301
Cambridge, MA 02138-1053
Phone
(646) 842-1707
NPI assigned
Sep 13, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHI3834 MA Primary

Addresses

Primary practice location

777 Concord Ave Ste 301
Cambridge, MA 02138-1053

Mailing address

777 Concord Ave Ste 301
Cambridge, MA 02138-1053
Phone (646) 842-1707

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231012001739 MA Practitioner - Chiropractic 4284089160 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHI3834MAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Lydian Chiropractic LLC Chiropractor CurrentSince Sep 28, 2023 Accepting new patients

Locations

777 Concord Ave
Ste 301
Cambridge, MA 02138
Phone (617) 876-6777

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": "1694563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694563200000",
    "number": "1407633217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 CONCORD AVE STE 301",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021381053",
            "telephone_number": "646-842-1707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 CONCORD AVE STE 301",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021381053",
            "telephone_number": "646-842-1707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MESSINEO",
        "first_name": "PHILLIP",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-13",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "CHI3834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.