Individual provider Active NPI

Alexis Samaniego, DC

  • Chiropractor
  • Orlando, FL
National Provider Identifier
1477987980
Registry record updated Sep 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH10980 Issued in FL
Practice address
4170 Town Ctr Blvd
Suite 100
Orlando, FL 32837-5873
Phone
(407) 857-6166
NPI assigned
Sep 3, 2013
Last updated
Sep 3, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 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 CH10980 FL Primary

Addresses

Primary practice location

4170 Town Ctr Blvd
Suite 100
Orlando, FL 32837-5873

Mailing address

4170 Town Ctr Blvd
Suite 100
Orlando, FL 32837-5873
Phone (407) 857-6166

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131203000788 FL Practitioner - Chiropractic 5496981193 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2013
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

39857 Hwy 27
Davenport, FL 33837-7802
Phone (863) 421-9000

827 Cypress Pkwy
Poinciana, FL 34759-3408
Phone (407) 530-5820

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sun Life Chiropractic and Injury Center LLC Chiropractor CurrentSince Feb 1, 2014 Accepting new patients

Locations

39857 Highway 27
Davenport, FL 33837
Phone (863) 421-9000

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, 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": "1378166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378166400000",
    "number": "1477987980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4170 TOWN CTR BLVD",
            "address_2": "SUITE 100",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328375873",
            "telephone_number": "407-857-6166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4170 TOWN CTR BLVD",
            "address_2": "SUITE 100",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328375873",
            "telephone_number": "407-857-6166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMANIEGO",
        "first_name": "ALEXIS",
        "name_prefix": "Mr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-03",
        "last_updated": "2013-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH10980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 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.