Active NPI
Jack R Siekerka, D.C.
- Chiropractor
- El Cajon, CA
National Provider Identifier
1598848566
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 21509
- Practice address
- 983 E Washington Ave
El Cajon, CA 92020-6611 - Phone
- (619) 447-3779
- Fax
- (619) 447-3899
- NPI assigned
- Oct 23, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 | 21509 | CA | Primary |
Addresses
Primary practice location
983 E Washington Ave
El Cajon, CA 92020-6611
Mailing address
983 E Washington Ave
El Cajon, CA 92020-6611
Phone (619) 447-3779
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110329000636 | CA | Practitioner - Chiropractic | 0446433429 | Practice locations: El Cajon, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Los Angeles College of Chiropractic, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
983 E Washington Ave
El Cajon, CA 92020-6611
Phone (619) 447-3779
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21509 | CA | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1282262400000",
"number": "1598848566",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "983 E WASHINGTON AVE",
"city": "EL CAJON",
"state": "CA",
"postal_code": "920206611",
"telephone_number": "619-447-3779",
"fax_number": "619-447-3899"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "983 E WASHINGTON AVE",
"city": "EL CAJON",
"state": "CA",
"postal_code": "920206611",
"telephone_number": "619-447-3779",
"fax_number": "619-447-3899"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIEKERKA",
"first_name": "JACK",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-23",
"last_updated": "2010-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "21509",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in El Cajon, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2010; 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.