Individual provider Active NPI

Cletus A. Simonetti

  • Chiropractor
  • Saratoga Springs, NY
National Provider Identifier
1447383369
Registry record updated Apr 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X007262 Issued in NY
Practice address
89 Edie Rd
Saratoga Springs, NY 12866-5429
Phone
(516) 782-2451
NPI assigned
Mar 13, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 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 X007262 NY Primary

Addresses

Primary practice location

89 Edie Rd
Saratoga Springs, NY 12866-5429

Mailing address

89 Edie Rd
Saratoga Springs, NY 12866-5429
Phone (516) 782-2451

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
X007262NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Nussbaum Chiropractic PLLC CurrentSince Feb 16, 2019 Accepting new patients

Locations

130 Everett Rd
Albany, NY 12205
Phone (518) 435-1280

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": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367193600000",
    "number": "1447383369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89 EDIE RD",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128665429",
            "telephone_number": "516-782-2451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 EDIE RD",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128665429",
            "telephone_number": "516-782-2451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONETTI",
        "first_name": "CLETUS",
        "middle_name": "A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-13",
        "last_updated": "2013-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X007262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saratoga Springs, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.