Individual provider Active NPI

Stephen Simonetti, D.C.

  • Chiropractor
  • Whitestone, NY
National Provider Identifier
1447312475
Registry record updated May 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
XX003564-1 Issued in NY
Practice address
708 149TH St
Whitestone, NY 11357-1641
Phone
(718) 746-4777
Fax
(718) 746-4739
NPI assigned
Dec 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X XX003564-1 NY Primary

Addresses

Primary practice location

708 149TH St
Whitestone, NY 11357-1641

Mailing address

708 149TH St
Whitestone, NY 11357-1641
Phone (718) 746-4777

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080708000411 NY Practitioner - Chiropractic 1254403215 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1983
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

708 149TH St
Whitestone, NY 11357-1641
Phone (718) 746-4777

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
XX003564-1NYMDChiropractor
003564NYMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Reborn Chiropractic PLLC Chiropractor CurrentSince Apr 1, 2003 Accepting new patients
Chiropractic Diagnostic Evaluations, P.C. Chiropractor PastSince Apr 1, 2003 Accepting new patients

Locations

708 149th St
Whitestone, NY 11357
Phone (347) 541-6683

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367798400000",
    "number": "1447312475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 149TH ST",
            "city": "WHITESTONE",
            "state": "NY",
            "postal_code": "113571641",
            "telephone_number": "718-746-4777",
            "fax_number": "718-746-4738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 149TH ST",
            "city": "WHITESTONE",
            "state": "NY",
            "postal_code": "113571641",
            "telephone_number": "718-746-4777",
            "fax_number": "718-746-4739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONETTI",
        "first_name": "STEPHEN",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-15",
        "last_updated": "2013-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "XX003564-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whitestone, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2013; 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.