Individual provider Active NPI

Ronald John Mostowski, DC

  • Chiropractor
  • Modesto, CA
National Provider Identifier
1639176944
Registry record updated Jan 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
15328 Issued in CA
Practice address
1500 Standiford Ave
BLDG.B
Modesto, CA 95350-0592
Phone
(209) 577-3300
Fax
(209) 577-3569
NPI assigned
Jun 30, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 15328 CA Primary

Addresses

Primary practice location

1500 Standiford Ave
BLDG.B
Modesto, CA 95350-0592

Mailing address

1500 Standiford Ave
BLDG.B
Modesto, CA 95350-0592
Phone (209) 577-3300

Other identifiers 1

IdentifierTypeStateIssuer
GDC000580MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050223000912 CA Practitioner - Chiropractic 8628021268 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1500 Standiford Ave
Suite B
Modesto, CA 95350-0592
Phone (209) 577-3300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15328CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Early Chiropractic Corporation Chiropractor PastSince Jul 31, 2006 Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674000000000",
    "number": "1639176944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 STANDIFORD AVE",
            "address_2": "BLDG.B",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953500592",
            "telephone_number": "209-577-3300",
            "fax_number": "209-577-3569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 STANDIFORD AVE",
            "address_2": "BLDG.B",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953500592",
            "telephone_number": "209-577-3300",
            "fax_number": "209-577-3569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSTOWSKI",
        "first_name": "RONALD",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-30",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "15328",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GDC000580",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2023; 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.