Individual provider Active NPI

Brian Martin Stuck, D.C.

  • Chiropractor
  • Normandy Park, WA
National Provider Identifier
1649467101
Registry record updated Sep 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00034778 Issued in WA
Practice address
17651 1St Ave S
Ste 101
Normandy Park, WA 98148-2715
Phone
(206) 241-3836
Fax
(206) 241-3967
NPI assigned
Sep 28, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 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 CH00034778 WA Primary

Addresses

Primary practice location

17651 1St Ave S
Ste 101
Normandy Park, WA 98148-2715

Mailing address

5029 Roosevelt Way NE Ste 101a
Seattle, WA 98105-3697
Phone (206) 547-4427

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151229002718 WA Practitioner - Chiropractic 8729380225 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mark S Jyringi DC PSGroup PAC ID 1557460334, 2 clinicians

Practice addresses (Care Compare)

5029 Roosevelt Way NE
101A
Seattle, WA 98105-3600

5029 Roosevelt Way NE
Suite 101a
Seattle, WA 98105-3697
Phone (206) 547-4427

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH00034778WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Leshaw Chiropractic PLLC PastSince Sep 1, 2019 Accepting new patients
Catherine Englehart DC PS Chiropractor Past Accepting new patients
Daryll G. Marshall-Inman DC Inc. Chiropractor PastSince May 23, 2017 Accepting new patients

Organizations & group practices 4

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": "1190937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695340800000",
    "number": "1649467101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5029 ROOSEVELT WAY NE STE 101A",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981053697",
            "telephone_number": "206-547-4427",
            "fax_number": "206-547-3587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17651 1ST AVE S",
            "address_2": "STE 101",
            "city": "NORMANDY PARK",
            "state": "WA",
            "postal_code": "981482715",
            "telephone_number": "206-241-3836",
            "fax_number": "206-241-3967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUCK",
        "first_name": "BRIAN",
        "middle_name": "MARTIN",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-28",
        "last_updated": "2023-09-22",
        "certification_date": "2023-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00034778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Normandy Park, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 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.