Individual provider Active NPI

Johanna Mae Lelke, D.C.

  • Chiropractor
  • Berkeley, CA
National Provider Identifier
1437482353
Registry record updated Apr 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC-31356 Issued in CA
Practice address
1250 Addison St.
Suite 102
Berkeley, CA 94702
Phone
(510) 883-1126
Fax
(510) 883-9926
NPI assigned
Sep 10, 2009
Last updated
Apr 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHR-6375 CO
Chiropractor 111N00000X DC-31356 CA Primary

Addresses

Primary practice location

1250 Addison St.
Suite 102
Berkeley, CA 94702

Mailing address

1530A 5TH St
Berkeley, CA 94710-1713
Phone (510) 510-1179

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NV2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200106000372 CA Practitioner - Chiropractic 9234563966 Reassigns benefits to 1 organization
I20240809003160 NV Practitioner - Chiropractic 9234563966 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lelke Chiropractic IncGroup PAC ID 8325472053, 4 clinicians

Practice addresses (Care Compare)

1530 A 5TH St
Berkeley, CA 94710-1713
Phone (510) 725-1179

180 W Huffaker LN
Suite 305
Reno, NV 89511-2091
Phone (775) 234-2141

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC-31356CAMDChiropractor
CHR-6375COMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Onsight Reno PLLC Chiropractor CurrentSince Jul 1, 2024 Accepting new patients
Lelke Chiropractic Inc. Chiropractor CurrentSince Oct 9, 2019 Accepting new patients
Innersport Chiropractic, LTD. Past Accepting new patients

Locations

1250 Addison St
Ste 102
Berkeley, CA 94702
Phone (510) 883-1126

1530 5th St
Berkeley, CA 94710
Phone (510) 488-3093

1530 5th St
#A
Berkeley, CA 94710

1530A 5th St
Berkeley, CA 94710
Phone (510) 305-4772

180 W Huffaker Ln
Ste 305
Reno, NV 89511
Phone (775) 234-2141

Organizations & group practices 3

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": "1252540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713484800000",
    "number": "1437482353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530A 5TH ST",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947101713",
            "telephone_number": "510-510-1179",
            "fax_number": "510-943-5252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 ADDISON ST.",
            "address_2": "SUITE 102",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "94702",
            "telephone_number": "510-883-1126",
            "fax_number": "510-883-9926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LELKE",
        "first_name": "JOHANNA",
        "middle_name": "MAE",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-10",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "CHR-6375",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC-31356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2024; 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.