Individual provider Active NPI

Richard Anthony Izzo, DC CCSP

  • Chiropractor
  • Rye Brook, NY
National Provider Identifier
1497765176
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X06499 Issued in NY
Practice address
63 South Ridge St
Rye Brook, NY 10573
Phone
(914) 251-1223
Fax
(914) 251-1226
NPI assigned
Aug 8, 2006
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 X06499 NY Primary

Addresses

Primary practice location

63 South Ridge St
Rye Brook, NY 10573

Mailing address

63 South Ridge St
Rye Brook, NY 10573
Phone (914) 251-1223

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040830000057 NY Practitioner - Chiropractic 5496720922 Practice locations: Rye Brook, NY

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

63 S Ridge St
Rye Brook, NY 10573-2810
Phone (914) 251-1223

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X06499NYMDChiropractor
006499NYMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497765176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 SOUTH RIDGE ST",
            "city": "RYE BROOK",
            "state": "NY",
            "postal_code": "10573",
            "telephone_number": "914-251-1223",
            "fax_number": "914-251-1226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 SOUTH RIDGE ST",
            "city": "RYE BROOK",
            "state": "NY",
            "postal_code": "10573",
            "telephone_number": "914-251-1223",
            "fax_number": "914-251-1226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IZZO",
        "first_name": "RICHARD",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "DC CCSP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X06499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rye Brook, 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.
  • 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.