Individual provider Active NPI

Perry Anthony Cammisa, DC

  • Chiropractor
  • Woodridge, IL
National Provider Identifier
1497853071
Registry record updated Jul 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038006843 Issued in IL
Practice address
3590 Hobson Rd
Ste 301
Woodridge, IL 60517-5409
Phone
(630) 778-9000
Fax
(630) 778-9065
NPI assigned
Sep 20, 2006
Last updated
Jul 9, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038006843 IL Primary

Addresses

Primary practice location

3590 Hobson Rd
Ste 301
Woodridge, IL 60517-5409

Mailing address

3590 Hobson Road
Ste 301
Woodridge, IL 60517
Phone (630) 778-9000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071129000205 IL Practitioner - Chiropractic 2466541420 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Canadian Memorial Chiropractic College, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ultimate Chiro Care PCGroup PAC ID 0547359507, 2 clinicians

Practice addresses (Care Compare)

3590 Hobson Rd
Woodridge, IL 60517-1472
Phone (630) 778-9000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038006843ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Ultimate Chiro Care PC Chiropractor CurrentSince Jul 31, 1991 Accepting new patients

Locations

3590 Hobson Rd
Ste 301
Woodridge, IL 60517
Phone (630) 778-9000

Interoperability endpoints

  • Direct secure messaging: perryucc@ucp0001.direct.chirotouch.md

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, 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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341792000000",
    "number": "1497853071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3590 HOBSON ROAD",
            "address_2": "STE 301",
            "city": "WOODRIDGE",
            "state": "IL",
            "postal_code": "60517",
            "telephone_number": "630-778-9000",
            "fax_number": "630-778-9065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3590 HOBSON RD",
            "address_2": "STE 301",
            "city": "WOODRIDGE",
            "state": "IL",
            "postal_code": "605175409",
            "telephone_number": "630-778-9000",
            "fax_number": "630-778-9065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMMISA",
        "first_name": "PERRY",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2012-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038006843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.