Individual provider Active NPI

Cesar Aldo Bernal Gallo, D.C.

  • Chiropractor
  • Seattle, WA
National Provider Identifier
1659515476
Registry record updated Nov 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH60159579 Issued in WA
Practice address
10223 16TH Ave SW
Seattle, WA 98146-1433
Phone
(206) 764-9600
Fax
(206) 762-6600
NPI assigned
Apr 23, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH60159579 WA Primary
Chiropractor 111N00000X 31234 CA

Addresses

Primary practice location

10223 16TH Ave SW
Seattle, WA 98146-1433

Mailing address

330 Meadow Ave N
Renton, WA 98057-5721
Phone (408) 569-6473

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240612004418 WA Practitioner - Chiropractic 7012459464 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Functional Health Consulting LLCGroup PAC ID 1759560709, 36 clinicians

Practice addresses (Care Compare)

15 SW Everett Mall Way
Suite G
Everett, WA 98204-2715
Phone (425) 355-5222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
31234CAMDChiropractor
CH60159579WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Functional Health Consulting, LLC Chiropractor CurrentSince Mar 31, 2024 Accepting new patients
Functional Health Consulting, LLC Current Accepting new patients
Hill Chiropractic, Inc. Chiropractor Past Accepting new patients
Functional Health Consulting, LLC PastSince Mar 31, 2024 Accepting new patients
Functional Health Consulting, LLC Past Accepting new patients

Locations

15 SW Everett Mall Way
Ste G
Everett, WA 98204
Phone (425) 355-5222

2014 E Madison St
Ste 100
Seattle, WA 98122
Phone (206) 726-9551

Organizations & group practices 5

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": "1240444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415145600000",
    "number": "1659515476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 MEADOW AVE N",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980575721",
            "telephone_number": "408-569-6473",
            "fax_number": "206-762-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10223 16TH AVE SW",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981461433",
            "telephone_number": "206-764-9600",
            "fax_number": "206-762-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNAL GALLO",
        "first_name": "CESAR",
        "middle_name": "ALDO",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-04-23",
        "last_updated": "2014-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH60159579",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "31234",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2014; 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.