Lighthouse Chiropractic, PC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

MD14078 Issued in RI

Legal business name

LIGHTHOUSE CHIROPRACTIC, PC

Practice address

717 Allens Ave
Providence, RI 02905-5412

Phone

(401) 751-6568

NPI assigned

Apr 7, 2010

Organization subpart

No

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

Authorized official

Name

Ronald TyszkowskiNPI 1336187004

Title

President

Phone

(401) 490-0494

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in RI

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ronald J Tyszkowski, DC

  • Chiropractor
  • Providence, RI
  • NPI 1336187004
  Medicare reassignment NPD Authorized official
• Afreen Siddiqui, MD

  • Pain Medicine (Anesthesiology) Physician
  • Warwick, RI
  • NPI 1649371493
  NPD (past)
• William Arthur Yelle, MD

  • Anesthesiology Physician
  • Providence, RI
  • NPI 1013007319
  NPD (past)
• Sergei Margulian, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Davie, FL
  • NPI 1659465573
  NPD (past)

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

{
    "created_epoch": "1270598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352851200000",
    "number": "1639495278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9117",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028890117",
            "telephone_number": "401-751-6568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 ALLENS AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029055412",
            "telephone_number": "401-751-6568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTHOUSE CHIROPRACTIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-07",
        "last_updated": "2012-11-14",
        "status": "A",
        "authorized_official_last_name": "TYSZKOWSKI",
        "authorized_official_first_name": "RONALD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "401-490-0494"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "RI",
            "license": "346",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "RI",
            "license": "MD14078",
            "primary": true
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "RI",
            "license": "MD14078",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lifespan Physician Group, Inc.
• Lifespan/Physicians Pso Billing Services
• Lifeworks, Inc
• Lifeworks, Inc
• Gary Douglas Light, D.M.D.
• Carlene Lesa Lighty-Fiorito, MED
• Like Home Adult Daycare Health Center, LLC
• Kwesi Lillard
• Elizabeth Lilly, RN
• Richard K Lim, M.D.

• Physical Medicine & Rehabilitation Physician in Providence, RI
• Providers in Providence, RI by specialty
• Physical Medicine & Rehabilitation Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.