Individual provider Active NPI

Evan Michael Kentish-Stack, DC

  • Chiropractor
  • Batavia, NY
National Provider Identifier
1508727652
Registry record updated Dec 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
014027 Issued in NY
Practice address
184 Washington Ave
Batavia, NY 14020-2113
Phone
(585) 343-9316
Fax
(585) 344-7031
NPI assigned
Nov 19, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 014027 NY Primary

Addresses

Primary practice location

184 Washington Ave
Batavia, NY 14020-2113

Mailing address

184 Washington Ave
Batavia, NY 14020-2113
Phone (585) 343-9316

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251222001006 NY Practitioner - Chiropractic 0446745079 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mazurkiewicz Family Chiropractic, PCGroup PAC ID 5193871077, 3 clinicians

Practice addresses (Care Compare)

184 Washington Ave
Batavia, NY 14020-2113
Phone (585) 343-9316

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
014027NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Mazurkiewicz Family Chiropractic, PC Chiropractor CurrentSince Dec 22, 2025 Accepting new patients

Locations

184 Washington Ave
Batavia, NY 14020
Phone (585) 343-9316

Organizations & group practices 1

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": "1763510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765756800000",
    "number": "1508727652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "184 WASHINGTON AVE",
            "city": "BATAVIA",
            "state": "NY",
            "postal_code": "140202113",
            "telephone_number": "585-343-9316",
            "fax_number": "585-344-7031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "184 WASHINGTON AVE",
            "city": "BATAVIA",
            "state": "NY",
            "postal_code": "140202113",
            "telephone_number": "585-343-9316",
            "fax_number": "585-344-7031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENTISH-STACK",
        "first_name": "EVAN",
        "middle_name": "MICHAEL",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-11-19",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "014027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Batavia, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2025; 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.