Individual provider Active NPI

David Russell Mote, DC

  • Chiropractor
  • Boynton Beach, FL
National Provider Identifier
1619941234
Registry record updated Oct 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH0006242 Issued in FL
Practice address
3111 Boynton Beach Blvd
Suite 200
Boynton Beach, FL 33436-4500
Phone
(561) 742-3283
Fax
(561) 742-3280
NPI assigned
Feb 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH0006242 FL Primary

Addresses

Primary practice location

3111 Boynton Beach Blvd
Suite 200
Boynton Beach, FL 33436-4500

Mailing address

3111 Boynton Beach Blvd
Suite 200
Boynton Beach, FL 33436-4500
Phone (561) 742-3283

Other identifiers 3

IdentifierTypeStateIssuer
380849100MedicaidFL
22533OtherFLBLUE CROSS BLUE SHIELD
603595500OtherFLOWCP

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040127000562 FL Practitioner - Chiropractic 7214839802 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3111 W Boynton Beach Blvd
Suite 200
Boynton Beach, FL 33436-4613
Phone (561) 742-3283

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH0006242FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Mote Wellness & Rehab Inc Chiropractor CurrentSince Jun 1, 2000 Accepting new patients
Palm Beach Aquatics & Physical Therapy Inc PastSince Oct 30, 2017 Accepting new patients

Locations

3111 W Boynton Beach Blvd
Ste 200
Boynton Beach, FL 33436
Phone (561) 742-3283

3925 W Boynton Beach Blvd
Ste 105
Boynton Beach, FL 33436
Phone (561) 742-3283

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222905600000",
    "number": "1619941234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3111 BOYNTON BEACH BLVD",
            "address_2": "SUITE 200",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334364500",
            "telephone_number": "561-742-3283",
            "fax_number": "561-742-3280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3111 BOYNTON BEACH BLVD",
            "address_2": "SUITE 200",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334364500",
            "telephone_number": "561-742-3283",
            "fax_number": "561-742-3280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOTE",
        "first_name": "DAVID",
        "middle_name": "RUSSELL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-13",
        "last_updated": "2008-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH0006242",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "380849100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "22533",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OWCP",
            "identifier": "603595500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2008; 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.