Active NPI
Anthony James Sirucek, D.C.
- Chiropractor
- Twin Falls, ID
National Provider Identifier
1477580025
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- C-436
- Practice address
- 263 2ND Ave N
Twin Falls, ID 83301-6117 - Phone
- (208) 733-5555
- Fax
- (208) 733-0687
- NPI assigned
- Jun 27, 2006
- Sex
- Male
- Sole proprietor
- No
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 | C-436 | ID | Primary |
Addresses
Primary practice location
263 2ND Ave N
Twin Falls, ID 83301-6117
Mailing address
263 2ND Ave N
Twin Falls, ID 83301-6117
Phone (208) 733-5555
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00010018812 | Other | ID | BLUE SHIELD OF IDAHO |
| C4363 | Other | ID | BLUE CROSS |
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
| License | State | Type | Specialty |
|---|---|---|---|
| C-436 | ID | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1477580025",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "263 2ND AVE N",
"city": "TWIN FALLS",
"state": "ID",
"postal_code": "833016117",
"telephone_number": "208-733-5555",
"fax_number": "208-733-0687"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "263 2ND AVE N",
"city": "TWIN FALLS",
"state": "ID",
"postal_code": "833016117",
"telephone_number": "208-733-5555",
"fax_number": "208-733-0687"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIRUCEK",
"first_name": "ANTHONY",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "ID",
"license": "C-436",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD OF IDAHO",
"identifier": "00010018812",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "C4363",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Twin Falls, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.