Active NPI
Jon Joseph Randazzo, DC
- Chiropractor
- Ozone Park, NY
National Provider Identifier
1639372022
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- X007603-1
- Practice address
- 10515 Liberty Ave
Ozone Park, NY 11417-1809 - Phone
- (718) 843-7720
- NPI assigned
- Jun 6, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | X007603-1 | NY | Primary |
Addresses
Primary practice location
10515 Liberty Ave
Ozone Park, NY 11417-1809
Mailing address
PO Box 70160
Staten Island, NY 10307-0160
Phone (718) 843-7720
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5897310 | Other | NY | GHI, GROUP HEALTH INC. # |
| 20-3202120 | Other | NY | NATIONAL HEALTH PLAN |
| CO 7603-1 | Other | NY | NEW YORK WORKERS COMP |
| P41-5011 | Other | NY | OXFORD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| X007603-1 | NY | MD | Chiropractor |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Chiropractor
- Ozone Park, NY
- NPI 1245401546
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317859200000",
"number": "1639372022",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 70160",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103070160",
"telephone_number": "718-843-7720"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10515 LIBERTY AVE",
"city": "OZONE PARK",
"state": "NY",
"postal_code": "114171809",
"telephone_number": "718-843-7720"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RANDAZZO",
"first_name": "JON",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-06-06",
"last_updated": "2011-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NY",
"license": "X007603-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI, GROUP HEALTH INC. #",
"identifier": "5897310",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NATIONAL HEALTH PLAN",
"identifier": "20-3202120",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEW YORK WORKERS COMP",
"identifier": "CO 7603-1",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD",
"identifier": "P41-5011",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ozone Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.