Individual provider Active NPI

Michael Wayne Rauch, D.C.

  • Chiropractor
  • Jamaica Plain, MA
National Provider Identifier
1407932130
Registry record updated Dec 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1126 Issued in MA
Practice address
329 Centre St Unit C
Jamaica Plain, MA 02130-1211
Phone
(617) 524-4878
Fax
(617) 524-0075
NPI assigned
Oct 27, 2006
Last updated
Dec 2, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1126 MA Primary

Addresses

Primary practice location

329 Centre St Unit C
Jamaica Plain, MA 02130-1211

Mailing address

10 Janet Rd Apt 1
South Easton, MA 02375-1621
Phone (774) 277-7400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060428000072 MA Practitioner - Chiropractic 3678583192 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1126MAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Spinal Rehab Group, LLC CurrentSince Jul 21, 2021 Accepting new patients
Proactive Chiropractic and Wellness PLLC Chiropractor Past Accepting new patients

Locations

111 Everett Ave
Ste 1A
Chelsea, MA 02150
Phone (617) 466-2687

329 Centre St
Ste C
Jamaica Plain, MA 02130
Phone (617) 524-4878

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638403200000",
    "number": "1407932130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 JANET RD APT 1",
            "city": "SOUTH EASTON",
            "state": "MA",
            "postal_code": "023751621",
            "telephone_number": "774-277-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "329 CENTRE ST UNIT C",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021301211",
            "telephone_number": "617-524-4878",
            "fax_number": "617-524-0075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAUCH",
        "first_name": "MICHAEL",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2021-12-02",
        "certification_date": "2021-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "1126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica Plain, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2021; 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.