Individual provider Active NPI

Paul James Quarneri, D.C., D.A.C.N.B.

  • Neurology Chiropractor
  • San Mateo, CA
National Provider Identifier
1497836068
Registry record updated Jun 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology ChiropractorTaxonomy code 111NN0400X
License
24755 Issued in CA
Practice address
177 Bovet Rd
Suite 150
San Mateo, CA 94402-3116
Phone
(650) 375-2545
Fax
(650) 655-6611
NPI assigned
Oct 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Chiropractor 111NN0400X 24755 CA Primary

Addresses

Primary practice location

177 Bovet Rd
Suite 150
San Mateo, CA 94402-3116

Mailing address

177 Bovet Rd
Suite 150
San Mateo, CA 94402-3117
Phone (650) 375-2545

Other identifiers 1

IdentifierTypeStateIssuer
DC0247550OtherCABLUE CROSS/BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081223000334 CA Practitioner - Chiropractic 4082776208 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1996
Medicare assignment
May accept Medicare assignment
Group practices
Quarneri Chiropractic IncGroup PAC ID 4486789419, 2 clinicians

Practice addresses (Care Compare)

177 Bovet Rd
Suite 150
San Mateo, CA 94402-3117
Phone (650) 375-2545

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
24755CAMDNeurology Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Quarneri Chiropractic Inc. Neurology CurrentSince Aug 1, 2006 Accepting new patients
Diane Au, L.Ac. Past Accepting new patients

Locations

177 Bovet Rd
Ste 150
San Mateo, CA 94402
Phone (650) 375-2545

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": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340582400000",
    "number": "1497836068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "177 BOVET RD",
            "address_2": "SUITE 150",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944023117",
            "telephone_number": "650-375-2545",
            "fax_number": "650-655-6611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 BOVET RD",
            "address_2": "SUITE 150",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944023116",
            "telephone_number": "650-375-2545",
            "fax_number": "650-655-6611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUARNERI",
        "first_name": "PAUL",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.C., D.A.C.N.B.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2012-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "CA",
            "license": "24755",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "DC0247550",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2012; 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.