Individual provider Active NPI

Andre E Voskressensky, D.C.

  • Chiropractor
  • Boca Raton, FL
National Provider Identifier
1538388244
Registry record updated Dec 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH0005425 Issued in FL
Practice address
9070 Kimberly Blvd Ste 58
Boca Raton, FL 33434-2861
Phone
(561) 990-3644
Fax
(954) 719-3764
NPI assigned
Apr 24, 2007
Last updated
Dec 23, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH0005425 FL Primary
Rehabilitation Chiropractor 111NR0400X CH0005425 FL

Addresses

Primary practice location

9070 Kimberly Blvd Ste 58
Boca Raton, FL 33434-2861

Mailing address

9070 Kimberly Blvd Ste 58
Boca Raton, FL 33434-2861
Phone (561) 990-3644

Other identifiers 2

IdentifierTypeStateIssuer
380208600MedicaidFL
70884OtherFLFLORIDABLUE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080422000322 FL Practitioner - Chiropractic 1254419963 Practice locations: Boca Raton, FL; Palm Springs, FL

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3923 Lake Worth Rd
Suite 116
Palm Springs, FL 33461-4049
Phone (561) 839-8566

9070 Kimberly Blvd
Suite 58
Boca Raton, FL 33434-2861
Phone (561) 929-0568

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH0005425FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Prakruti LLC PastSince Jun 16, 2024 Accepting new patients
Prakruti LLC PastSince Jun 11, 2023 Accepting new patients
Furshman and Davis Chiropractic Centers Inc Chiropractor Past Accepting new patients
Furshman and Davis Chiropractic Centers Inc Chiropractor Past Accepting new patients

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": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608681600000",
    "number": "1538388244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9070 KIMBERLY BLVD STE 58",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334342861",
            "telephone_number": "561-990-3644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9070 KIMBERLY BLVD STE 58",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334342861",
            "telephone_number": "561-990-3644",
            "fax_number": "954-719-3764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VOSKRESSENSKY",
        "first_name": "ANDRE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2020-12-23",
        "certification_date": "2020-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH0005425",
            "primary": true
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "FL",
            "license": "CH0005425",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "380208600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDABLUE",
            "identifier": "70884",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2020; 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.