Individual provider Active NPI

Ryan Emmanuel Spicuzzo, DC

  • Chiropractor
  • Deerfield Beach, FL
National Provider Identifier
1548564982
Registry record updated Oct 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH10306 Issued in FL
Practice address
100 S Military TRL Ste 33
Deerfield Beach, FL 33442-3032
Phone
(954) 570-4080
Fax
(954) 697-0497
NPI assigned
Dec 28, 2010
Last updated
Oct 9, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH10306 FL Primary

Addresses

Primary practice location

100 S Military TRL Ste 33
Deerfield Beach, FL 33442-3032

Mailing address

2125 Park PL
Boca Raton, FL 33486-3132
Phone (561) 797-5132

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110930000558 FL Practitioner - Chiropractic 2466638432 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

100 S Military TR
Suite 18
Deerfield Beach, FL 33442-3031

100 S Military TRL
Suite 18
Deerfield Beach, FL 33442-3031
Phone (954) 570-4080

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
009396NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Spicuzzo Chiropractic, LLC CurrentSince Feb 24, 2014 Accepting new patients
Lance Wald DC PA Chiropractor Past Accepting new patients
Quartell Chiropractic Chiropractor PastSince Aug 17, 2011 Accepting new patients
Pga Medical Center, Inc. Chiropractor Past Accepting new patients

Locations

100 S Military Trl
Ste 18
Deerfield Beach, FL 33442
Phone (954) 570-4080

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": "1293494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696809600000",
    "number": "1548564982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2125 PARK PL",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334863132",
            "telephone_number": "561-797-5132",
            "fax_number": "954-697-0497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S MILITARY TRL STE 33",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "334423032",
            "telephone_number": "954-570-4080",
            "fax_number": "954-697-0497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPICUZZO",
        "first_name": "RYAN",
        "middle_name": "EMMANUEL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-12-28",
        "last_updated": "2023-10-09",
        "certification_date": "2023-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH10306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deerfield Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2023; 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.