Individual provider Active NPI

Paul Andrew Richetto, D.C.

  • Chiropractor
  • Phoenix, AZ
National Provider Identifier
1467632760
Registry record updated Mar 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
7873 Issued in AZ
Practice address
2222 W Dunlap Ave Ste 190
Phoenix, AZ 85021-2800
Phone
(602) 584-9661
Fax
(720) 925-5897
NPI assigned
Nov 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 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 7873 AZ Primary
Rehabilitation Chiropractor 111NR0400X 4562 AZ

Addresses

Primary practice location

2222 W Dunlap Ave Ste 190
Phoenix, AZ 85021-2800

Mailing address

5445 DTC Pkwy Ste 1130
Greenwood Village, CO 80111-3038
Phone (720) 749-5599

Other practice location 1

2163 E Baseline Rd
Suite 105
Tempe, AZ 85283-1541
Phone (480) 775-3508

Other names 1

  • P. Andrew Richetto Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110221000855 AZ Practitioner - ChiropracticPractitioner - Physical Medicine and Rehabilitation 9830383587 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4562AZMDNeuroradiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain View Pain Center Chiropractor CurrentSince Aug 22, 2023 Accepting new patients
Advanced Spine and Pain LLC Chiropractor Past Accepting new patients
Mountain View Pain Specialists PastSince Mar 17, 2024 Accepting new patients

Locations

6622 N 91st Ave
Ste 230
Glendale, AZ 85305
Phone (602) 325-2024

2222 W Dunlap Ave
Ste 190
Phoenix, AZ 85021
Phone (602) 325-2024

5445 Dtc Pkwy
Ste 1130
Greenwood Village, CO 80111

Interoperability endpoints

  • Direct secure messaging: paul.richetto@asapl-az.direct.office.nextgen.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1194220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1467632760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5445 DTC PKWY STE 1130",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801113038",
            "telephone_number": "720-749-5599",
            "fax_number": "720-925-5897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 W DUNLAP AVE STE 190",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850212800",
            "telephone_number": "602-584-9661",
            "fax_number": "720-925-5897"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2163 E Baseline Rd",
            "address_2": "Suite 105",
            "address_purpose": "LOCATION",
            "city": "Tempe",
            "state": "AZ",
            "postal_code": "852831541",
            "country_code": "US",
            "telephone_number": "480-775-3508",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICHETTO",
        "first_name": "PAUL",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-05",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "7873",
            "primary": true
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "AZ",
            "license": "4562",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "P.",
            "last_name": "RICHETTO",
            "middle_name": "ANDREW",
            "credential": "D.C.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.