Individual provider Active NPI

Michael Vanchieri, DC

  • Chiropractor
  • Island Park, NY
National Provider Identifier
1518473479
Registry record updated Dec 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
012978 Issued in NY
Practice address
4454 Austin Boulevard
Island Park, NY 11558-1155
Phone
(630) 567-7718
Fax
(630) 567-7718
NPI assigned
Dec 14, 2017
Last updated
Dec 14, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 012978 NY Primary

Addresses

Primary practice location

4454 Austin Boulevard
Island Park, NY 11558-1155

Mailing address

4454 Austin Blvd
Island Park, NY 11558-1621
Phone (630) 567-7718

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
012978NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Physio Logic Medicine, P.C. CurrentSince Oct 14, 2018 Accepting new patients

Locations

409 Fulton St
#2
Brooklyn, NY 11201
Phone (718) 260-1000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16096/brand/2/csg/1/fhir/r4

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, 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": "1513209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513209600000",
    "number": "1518473479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4454 AUSTIN BLVD",
            "city": "ISLAND PARK",
            "state": "NY",
            "postal_code": "115581621",
            "telephone_number": "630-567-7718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4454 AUSTIN BOULEVARD",
            "city": "ISLAND PARK",
            "state": "NY",
            "postal_code": "115581155",
            "telephone_number": "630-567-7718",
            "fax_number": "630-567-7718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANCHIERI",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-14",
        "last_updated": "2017-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "012978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Island Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.