Active NPI
Mark V Riccabona, D.C.
- Chiropractor
- San Francisco, CA
National Provider Identifier
1407966971
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC22827
- Practice address
- 345 Spear St
#105
San Francisco, CA 94105-1673 - Phone
- (415) 495-2273
- Fax
- (415) 243-9605
- NPI assigned
- Aug 30, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC22827 | CA | Primary |
Addresses
Primary practice location
345 Spear St
#105
San Francisco, CA 94105-1673
Mailing address
345 Spear St
Suite 105
San Francisco, CA 94105-1673
Phone (415) 495-2273
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DC0228270 | Other | CA | BLUE SHIELD PROVIDER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC22827 | CA | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SC Sportstherapy | Chiropractor | Past | Accepting new patients |
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.
-
- Chiropractor
- San Francisco, CA
- NPI 1184834517
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1442448000000",
"number": "1407966971",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "345 SPEAR ST",
"address_2": "SUITE 105",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941051673",
"telephone_number": "415-495-2273",
"fax_number": "415-243-9605"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "345 SPEAR ST",
"address_2": "#105",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941051673",
"telephone_number": "415-495-2273",
"fax_number": "415-243-9605"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICCABONA",
"first_name": "MARK",
"middle_name": "V",
"name_prefix": "Mr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-30",
"last_updated": "2015-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC22827",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD PROVIDER",
"identifier": "DC0228270",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.