Individual provider Active NPI

Angelo George Charonis, D.C.

  • Chiropractor
  • Redwood City, CA
National Provider Identifier
1407943251
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC-27902 Issued in CA
Practice address
250C Twin Dolphin Dr
Redwood City, CA 94065-1402
Phone
(650) 631-1500
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
Yes

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 DC-27902 CA Primary

Addresses

Primary practice location

250C Twin Dolphin Dr
Redwood City, CA 94065-1402

Mailing address

250C Twin Dolphin Dr
Redwood City, CA 94065-1402
Phone (650) 631-1500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101203000386 CA Practitioner - Chiropractic 9234326299 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1682 Laurel St
Suite a
San Carlos, CA 94070-5245
Phone (650) 631-1500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC-27902CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Charonis Chiropractic Corporation Chiropractor CurrentSince Jan 21, 2008 Accepting new patients

Locations

1682 Laurel St
Ste A
San Carlos, CA 94070
Phone (650) 631-1500

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407943251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250C TWIN DOLPHIN DR",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940651402",
            "telephone_number": "650-631-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250C TWIN DOLPHIN DR",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940651402",
            "telephone_number": "650-631-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARONIS",
        "first_name": "ANGELO",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC-27902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redwood City, CA

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.
  • 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.