Individual provider Active NPI

Ryan P Rademacker, D.C.

  • Chiropractor
  • Canandaigua, NY
National Provider Identifier
1659468551
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X010717-1 Issued in NY
Practice address
23 North St
Suite 7
Canandaigua, NY 14424-1053
Phone
(585) 394-8430
Fax
(585) 394-8154
NPI assigned
Oct 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 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 X010717-1 NY Primary

Addresses

Primary practice location

23 North St
Suite 7
Canandaigua, NY 14424-1053

Mailing address

23 North St
Suite 7
Canandaigua, NY 14424-1053
Phone (585) 394-8430

Other identifiers 1

IdentifierTypeStateIssuer
838800OtherNYMANANGED PHYICAL NETWORK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040623000258 NY Practitioner - Chiropractic 5092799056 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X010717-1NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Rademacker Specific Chiropractic, P.C. Chiropractor CurrentSince Mar 29, 2004 Accepting new patients

Locations

23 North St
Ste 7
Canandaigua, NY 14424
Phone (585) 394-8430

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659468551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 NORTH ST",
            "address_2": "SUITE 7",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144241053",
            "telephone_number": "585-394-8430",
            "fax_number": "585-394-8154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 NORTH ST",
            "address_2": "SUITE 7",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144241053",
            "telephone_number": "585-394-8430",
            "fax_number": "585-394-8154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADEMACKER",
        "first_name": "RYAN",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X010717-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MANANGED PHYICAL NETWORK",
            "identifier": "838800",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canandaigua, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.