Active NPI
Nicholas Destito, D.C.
- Chiropractor
- Rome, NY
National Provider Identifier
1598124174
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- X012944-1
- 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, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| X012944-1 | NY | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Chiropractor
- Rome, NY
- NPI 1487290540
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.