Individual provider Active NPI

Mark Anthony, D.C.

  • Chiropractor
  • La Crescenta, CA
National Provider Identifier
1619063575
Registry record updated Feb 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC13928 Issued in CA
Practice address
3935 Foothill Blvd
La Crescenta, CA 91214-1621
Phone
(818) 957-7035
Fax
(818) 957-7017
NPI assigned
Oct 5, 2006
Last updated
Feb 28, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC13928 CA Primary

Addresses

Primary practice location

3935 Foothill Blvd
La Crescenta, CA 91214-1621

Mailing address

15520 Rockfield Blvd
Ste A200
Irvine, CA 92618-6705
Phone (949) 598-9999

Other identifiers 1

IdentifierTypeStateIssuer
DC0139280OtherCABLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080411000486 CA Practitioner - Chiropractic 2466539622 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Los Angeles, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3935 Foothill Blvd
La Crescenta, CA 91214-1621
Phone (818) 957-7035

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC13928CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Anthony Chiropractic Inc Chiropractor CurrentSince Mar 1, 2001 Accepting new patients
Diaso Chiropractic Professional Corporation Chiropractor CurrentSince Oct 4, 2023 Accepting new patients
1St Defense Inc PastSince Mar 1, 2001 Accepting new patients

Locations

2150 Main St
Cambria, CA 93428
Phone (805) 395-3277

15520 Rockfield Blvd
Ste A200
Irvine, CA 92618

15550 Rockfield Blvd
Ste B220
Irvine, CA 92618

3935 Foothill Blvd
La Crescenta, CA 91214
Phone (818) 249-9181

Organizations & group practices 3

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582848000000",
    "number": "1619063575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15520 ROCKFIELD BLVD",
            "address_2": "STE A200",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926186705",
            "telephone_number": "949-598-9999",
            "fax_number": "949-598-9990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3935 FOOTHILL BLVD",
            "city": "LA CRESCENTA",
            "state": "CA",
            "postal_code": "912141621",
            "telephone_number": "818-957-7035",
            "fax_number": "818-957-7017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTHONY",
        "first_name": "MARK",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2020-02-28",
        "certification_date": "2020-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC13928",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "DC0139280",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crescenta, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2020; 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.