Individual provider Active NPI

David Boyd Eagan, DC

  • Chiropractor
  • Lynn, MA
National Provider Identifier
1639291362
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2527 Issued in MA
Practice address
30 Boston St
Lynn, MA 01904-2540
Phone
(781) 599-8826
Fax
(781) 596-2156
NPI assigned
Apr 4, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2527 MA Primary

Addresses

Primary practice location

30 Boston St
Lynn, MA 01904-2540

Mailing address

30 Boston St
Lynn, MA 01904-2540
Phone (781) 599-8826

Other identifiers 6

IdentifierTypeStateIssuer
661194OtherMAUNITED HEALTH PROVIDER #
2453050OtherMAAETNA PROVIDER #
6399335OtherMACIGNA PROVIDER #
467545OtherMATUFTTS PROVIDER #
1696777OtherMAMASSHEALTH PROVIDER #
AA34472OtherMAHARVARD PROVIDER #

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031208000519 MA Practitioner - Chiropractic 7618873167 Practice locations: Lynn, MA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

30 Boston St
Lynn, MA 01904-2540
Phone (781) 599-8826

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2527MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kornfeld Chiropractic Inc Chiropractor PastSince Oct 1, 2019 Accepting new patients
Moramarco Chiropractic Offices, PC Chiropractor Past Accepting new patients
Moramarco Chiropractic Office, P.C. Chiropractor PastSince Oct 7, 2003 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1639291362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 BOSTON ST",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019042540",
            "telephone_number": "781-599-8826",
            "fax_number": "781-596-2156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 BOSTON ST",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019042540",
            "telephone_number": "781-599-8826",
            "fax_number": "781-596-2156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EAGAN",
        "first_name": "DAVID",
        "middle_name": "BOYD",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-04",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "2527",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH PROVIDER #",
            "identifier": "661194",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER #",
            "identifier": "2453050",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PROVIDER #",
            "identifier": "6399335",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTTS PROVIDER #",
            "identifier": "467545",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASSHEALTH PROVIDER #",
            "identifier": "1696777",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PROVIDER #",
            "identifier": "AA34472",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynn, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.