Individual provider Active NPI

Michael Anthony Pascavage, D.C.

  • Chiropractor
  • Collegeville, PA
National Provider Identifier
1497795439
Registry record updated Aug 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC007845L Issued in PA
Practice address
555 Second Ave
Suite D-202
Collegeville, PA 19426-3600
Phone
(610) 454-9825
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC007845L PA Primary

Addresses

Primary practice location

555 Second Ave
Suite D-202
Collegeville, PA 19426-3600

Mailing address

41 Ruth Ave
Phoenixville, PA 19460-1917

Other identifiers 3

IdentifierTypeStateIssuer
0804114000OtherPAIBC
1041595OtherPACIGNA
2458557OtherPAAETNA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120118000340 PA Practitioner - Chiropractic 0749457679 Practice locations: Collegeville, PA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2000
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

555 2ND Ave
Collegeville, PA 19426-3622
Phone (610) 454-9825

555 2ND Ave
Suite 202
Collegeville, PA 19426

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC007845LPAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439942400000",
    "number": "1497795439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 RUTH AVE",
            "city": "PHOENIXVILLE",
            "state": "PA",
            "postal_code": "194601917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 SECOND AVE",
            "address_2": "SUITE D-202",
            "city": "COLLEGEVILLE",
            "state": "PA",
            "postal_code": "194263600",
            "telephone_number": "610-454-9825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASCAVAGE",
        "first_name": "MICHAEL",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2015-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC007845L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IBC",
            "identifier": "0804114000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1041595",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2458557",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Collegeville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2015; 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.