Active NPI
Brian Joseph Declerk, D.C.
- Chiropractor
- Oceanside, CA
National Provider Identifier
1598857013
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC17664
- Practice address
- 3529 Cannon Rd Ste 2E
Oceanside, CA 92056-4979 - Phone
- (760) 631-8000
- Fax
- (760) 631-8099
- NPI assigned
- Sep 29, 2006
- 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 | DC17664 | CA | Primary |
Addresses
Primary practice location
3529 Cannon Rd Ste 2E
Oceanside, CA 92056-4979
Mailing address
3529 Cannon Rd Ste 2E
Oceanside, CA 92056-4979
Phone (760) 631-8000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 931150 | Other | CA | QME |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130313000424 | CA | Practitioner - Chiropractic | 2668627951 | Practice locations: Oceanside, CA |
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)
3529 Cannon Rd
Oceanside, CA 92056-4979
Phone (760) 631-8000
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC17664 | CA | MD | Chiropractor |
| 17664 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1598857013",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3529 CANNON RD STE 2E",
"city": "OCEANSIDE",
"state": "CA",
"postal_code": "920564979",
"telephone_number": "760-631-8000",
"fax_number": "760-631-8099"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3529 CANNON RD STE 2E",
"city": "OCEANSIDE",
"state": "CA",
"postal_code": "920564979",
"telephone_number": "760-631-8000",
"fax_number": "760-631-8099"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DECLERK",
"first_name": "BRIAN",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC17664",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "QME",
"identifier": "931150",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oceanside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.