Organization Active NPI

ASC Wellness LLC

  • Chiropractor
  • Mayfield Village, OH
National Provider Identifier
1609353630
Registry record updated Jan 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
OH3327 Issued in OH
Legal business name
ASC WELLNESS LLC
Doing business as
Advanced Spinal Care Center
Practice address
6501 Wilson Mills Rd Ste B
Mayfield Village, OH 44143-3442
Phone
(440) 461-9774
Fax
(440) 943-6716
NPI assigned
Jul 23, 2018
Organization subpart
Yes
Parent organization
ASC WELLNESS LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 11, 2024

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

Authorized official

Name
Dr. Michael P Polsinelli, D.C.NPI 1538280623
Title
Owner
Phone
(440) 461-9774

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X OH3327 OH Primary

Addresses

Primary practice location

6501 Wilson Mills Rd Ste B
Mayfield Village, OH 44143-3442

Mailing address

6501 Wilson Mills Rd Ste B
Mayfield Village, OH 44143-3442
Phone (440) 461-9774

Other identifiers 1

IdentifierTypeStateIssuer
H674460OtherOHMEDICARE - PTAN

Other names 1

  • Advanced Spinal Care Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181010002139 OH Part B Supplier - Clinic/Group Practice 9830441377 Receives reassigned benefits from 1 practitioner
Practice locations: Mayfield Village, OH

National Provider Directory

National Provider Directory
Part of
ASC Wellness LLC

Locations

6501 Wilson Mills Rd
Ste B
Mayfield Vlg, OH 44143
Phone (440) 461-9774

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1532304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704931200000",
    "number": "1609353630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6501 WILSON MILLS RD STE B",
            "city": "MAYFIELD VILLAGE",
            "state": "OH",
            "postal_code": "441433442",
            "telephone_number": "440-461-9774",
            "fax_number": "440-943-6716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6501 WILSON MILLS RD STE B",
            "city": "MAYFIELD VILLAGE",
            "state": "OH",
            "postal_code": "441433442",
            "telephone_number": "440-461-9774",
            "fax_number": "440-943-6716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASC WELLNESS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ASC WELLNESS LLC",
        "enumeration_date": "2018-07-23",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A",
        "authorized_official_last_name": "POLSINELLI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "440-461-9774",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "OH3327",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE - PTAN",
            "identifier": "H674460",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Spinal Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mayfield Village, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.