Individual provider Active NPI

Nicholas Destito, D.C.

  • Chiropractor
  • Rome, NY
National Provider Identifier
1598124174
Registry record updated Apr 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X012944-1 Issued in NY
Practice address
143 North Washington St
Rome, NY 13440-3442
Phone
(315) 339-2422
Fax
(315) 733-5024
NPI assigned
Feb 11, 2016
Last updated
Apr 28, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 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 X012944-1 NY Primary

Addresses

Primary practice location

143 North Washington St
Rome, NY 13440-3442

Mailing address

143 N Washington Street
Rome, NY 13440
Phone (315) 339-2422

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180315001521 NY Practitioner - Chiropractic 3870871676 Practice locations: Rome, NY

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

143 N Washington St
Rome, NY 13440-3442

420 N Washington St
Rome, NY 13440-5161
Phone (315) 356-7381

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X012944-1NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Copper City Chiropractic Chiropractor Current Accepting new patients

Locations

143 N Washington St
Rome, NY 13440
Phone (315) 337-7050

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": "1455148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493337600000",
    "number": "1598124174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 N WASHINGTON STREET",
            "city": "ROME",
            "state": "NY",
            "postal_code": "13440",
            "telephone_number": "315-339-2422",
            "fax_number": "315-733-5024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 NORTH WASHINGTON ST",
            "city": "ROME",
            "state": "NY",
            "postal_code": "134403442",
            "telephone_number": "315-339-2422",
            "fax_number": "315-733-5024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESTITO",
        "first_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-11",
        "last_updated": "2017-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X012944-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rome, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2017; 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.