Individual provider Active NPI

Maggie Pezeshkian, D.C.

  • Chiropractor
  • Duarte, CA
National Provider Identifier
1649292608
Registry record updated Dec 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC29523 Issued in CA
Practice address
924 Buena Vista St
Ste. 103
Duarte, CA 91010-1779
Phone
(626) 359-3956
Fax
(626) 359-3247
NPI assigned
Jul 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Chiropractor 111NN1001X DC29523 CA
Sports Physician Chiropractor 111NS0005X DC29523 CA
Occupational Health Chiropractor 111NX0100X DC29523 CA
Chiropractor 111N00000X DC29523 CA Primary

Addresses

Primary practice location

924 Buena Vista St
Ste. 103
Duarte, CA 91010-1779

Mailing address

924 Buena Vista St
Ste. 103
Duarte, CA 91010-1779
Phone (626) 359-3956

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050419000688 CA Practitioner - Chiropractic 7113965302 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Los Angeles, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

924 Buena Vista St
Suite 103
Duarte, CA 91010-1779
Phone (626) 359-3956

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC29523CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
McHaney Chiropractic Corporation Chiropractor CurrentSince Aug 1, 2007 Accepting new patients
Pezeshkian Chiropractic PC Chiropractor Current Accepting new patients

Locations

924 Buena Vista St
Ste 103
Duarte, CA 91010
Phone (626) 359-3956

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": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672272000000",
    "number": "1649292608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "924 BUENA VISTA ST",
            "address_2": "STE. 103",
            "city": "DUARTE",
            "state": "CA",
            "postal_code": "910101779",
            "telephone_number": "626-359-3956",
            "fax_number": "626-359-3247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "924 BUENA VISTA ST",
            "address_2": "STE. 103",
            "city": "DUARTE",
            "state": "CA",
            "postal_code": "910101779",
            "telephone_number": "626-359-3956",
            "fax_number": "626-359-3247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEZESHKIAN",
        "first_name": "MAGGIE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2022-12-29",
        "certification_date": "2022-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "CA",
            "license": "DC29523",
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "CA",
            "license": "DC29523",
            "primary": false
        },
        {
            "code": "111NX0100X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Occupational Health",
            "state": "CA",
            "license": "DC29523",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC29523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duarte, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2022; 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.