Individual provider Active NPI

David Brian Iadeluca, D.C.

  • Chiropractor
  • Erie, PA
National Provider Identifier
1497862700
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC007310-L Issued in PA
Practice address
3721 Poplar St
Erie, PA 16508-2651
Phone
(814) 864-9775
Fax
(814) 864-7227
NPI assigned
Aug 23, 2006
Sex
Male
Sole proprietor
Yes

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 DC007310-L PA Primary

Addresses

Primary practice location

3721 Poplar St
Erie, PA 16508-2651

Mailing address

3721 Poplar Street
Erie, PA 16508
Phone (814) 864-9775

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040628001145 PA Practitioner - Chiropractic 0345226528 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iadeluca Chiropractic Center IncGroup PAC ID 5092806513, 3 clinicians

Practice addresses (Care Compare)

2921 W 26TH St
Erie, PA 16506-2501
Phone (814) 459-2580

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC007310-LPAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Iadeluca Chiropractic Center Corry PC Chiropractor CurrentSince May 1, 2021 Accepting new patients
Iadeluca Chiropractic Center Meadville PC Chiropractor CurrentSince Jan 1, 2021 Accepting new patients
Iadeluca Chiropractic Center Inc Chiropractor CurrentSince May 27, 2004 Accepting new patients
Jack K. Vandervort Chiropractor PastSince Jun 15, 2012 Accepting new patients

Locations

110 E Columbus Ave
Corry, PA 16407
Phone (814) 459-2580

1990 Nagle Rd
Erie, PA 16510
Phone (814) 899-0691

2921 W 26th St
Erie, PA 16506
Phone (814) 459-2580

1334 W 26th St
Erie, PA 16508
Phone (814) 459-2580

3721 Poplar St
Erie, PA 16508
Phone (814) 864-9775

Organizations & group practices 4

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": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497862700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3721 POPLAR STREET",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "16508",
            "telephone_number": "814-864-9775",
            "fax_number": "814-864-7227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3721 POPLAR ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165082651",
            "telephone_number": "814-864-9775",
            "fax_number": "814-864-7227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IADELUCA",
        "first_name": "DAVID",
        "middle_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC007310-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

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.