Individual provider Active NPI

Matthew Lorenzo Trinidad, DC

  • Chiropractor
  • Hammond, IN
National Provider Identifier
1487328316
Registry record updated Apr 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08003217A Issued in IN
Practice address
1828 165TH St Ste a
Hammond, IN 46320-2823
Phone
(219) 763-8112
Fax
(219) 764-5333
NPI assigned
Aug 4, 2021
Last updated
Apr 8, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 08003217A IN Primary

Addresses

Primary practice location

1828 165TH St Ste a
Hammond, IN 46320-2823

Mailing address

PO Box 1430
Portage, IN 46368-9230
Phone (219) 763-8112

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220502000317 IN Practitioner - Chiropractic 0648667196 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northshore Health Centers IncGroup PAC ID 5799671236, 31 clinicians

Practice addresses (Care Compare)

2490 Central Ave
Lake Station, IN 46405-2122
Phone (219) 763-8112

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Northshore Health Centers, Inc Chiropractor CurrentSince Jun 6, 2022 Accepting new patients
Northshore Health Centers Inc Current Accepting new patients
Northshore Health Centers, Inc. CurrentSince Jun 6, 2022 Accepting new patients

Locations

1828 165th St
Hammond, IN 46320
Phone (219) 644-3957

1828 165th St
Ste A
Hammond, IN 46320
Phone (219) 764-5349

2490 Central Ave
Lake Station, IN 46405

6050 Sterling Creek Rd
Portage, IN 46368
Phone (219) 212-0188

Interoperability endpoints

  • Direct secure messaging: matthew.trinidad.p1@direct.northshorehealth.nextgenshare.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, 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": "1628035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649376000000",
    "number": "1487328316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1430",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463689230",
            "telephone_number": "219-763-8112",
            "fax_number": "219-764-5333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1828 165TH ST STE A",
            "city": "HAMMOND",
            "state": "IN",
            "postal_code": "463202823",
            "telephone_number": "219-763-8112",
            "fax_number": "219-764-5333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRINIDAD",
        "first_name": "MATTHEW",
        "middle_name": "LORENZO",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-04",
        "last_updated": "2022-04-08",
        "certification_date": "2022-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08003217A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hammond, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2022; 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.