Individual provider Active NPI

Mark D Losagio, DC,DIBCN

  • Neurology Chiropractor
  • Bethlehem, PA
National Provider Identifier
1629037825
Registry record updated Sep 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology ChiropractorTaxonomy code 111NN0400X
License
DC003864L Issued in PA
Practice address
1220 Illicks Mill Rd
Bethlehem, PA 18017-3654
Phone
(610) 865-8155
Fax
(610) 758-8998
NPI assigned
Mar 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Chiropractor 111NN0400X DC003864L PA Primary
Chiropractor 111N00000X DC003864L PA

Addresses

Primary practice location

1220 Illicks Mill Rd
Bethlehem, PA 18017-3654

Mailing address

1220 Illicks Mill Rd
Bethlehem, PA 18017-3654
Phone (610) 865-8155

Other identifiers 1

IdentifierTypeStateIssuer
0011539800002MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101110001169 PA Practitioner - Chiropractic 7315132768 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3735 Easton Nazareth Hwy
Suite 103
Easton, PA 18045-8345
Phone (610) 865-8155

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC003864LPAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Losagio Chiropractic Center Inc Neurology CurrentSince Dec 16, 1988 Accepting new patients

Locations

1220 Illicks Mill Rd
#D
Bethlehem, PA 18017

1220 Illicks Mill Rd
Bethlehem, PA 18017
Phone (610) 865-8155

3735 Nazareth Rd
Ste 103
Easton, PA 18045
Phone (610) 252-1999

Organizations & group practices 1

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": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410825600000",
    "number": "1629037825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 ILLICKS MILL RD",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180173654",
            "telephone_number": "610-865-8155",
            "fax_number": "610-758-8998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 ILLICKS MILL RD",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180173654",
            "telephone_number": "610-865-8155",
            "fax_number": "610-758-8998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOSAGIO",
        "first_name": "MARK",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DC,DIBCN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2014-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "PA",
            "license": "DC003864L",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC003864L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011539800002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethlehem, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2014; 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.