Individual provider Active NPI

Lawrence A Opisso, DC

  • Chiropractor
  • West Islip, NY
National Provider Identifier
1487711941
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X4173 Issued in NY
Practice address
1253 Montauk Highway
West Islip, NY 11795-4916
Phone
(631) 661-1400
Fax
(631) 661-5242
NPI assigned
Jan 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X4173 NY Primary

Addresses

Primary practice location

1253 Montauk Highway
West Islip, NY 11795-4916

Mailing address

1253 Montauk Highway
West Islip, NY 11795-4916
Phone (631) 661-1400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060427000549 NY Practitioner - Chiropractic 7214947787 Reassigns benefits to 1 organization
Practice locations: West Islip, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X4173NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Long Island Chiropractic & Physical Therapy, PLLC Chiropractor CurrentSince Jun 15, 2018 Accepting new patients
West Islip Chiropractic, Physical Therapy, Acupuncture, and Adult Health NP, PLLC Chiropractor PastSince Mar 20, 2025 Accepting new patients

Locations

20 Gilbert Ave
Ste 201
Smithtown, NY 11787
Phone (631) 724-1991

786 Montauk Hwy
Uppr
West Islip, NY 11795
Phone (631) 661-1400

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487711941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1253 MONTAUK HIGHWAY",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954916",
            "telephone_number": "631-661-1400",
            "fax_number": "631-661-5242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1253 MONTAUK HIGHWAY",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954916",
            "telephone_number": "631-661-1400",
            "fax_number": "631-661-5242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OPISSO",
        "first_name": "LAWRENCE",
        "middle_name": "A",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X4173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Islip, NY

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.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.