Philip John Derleth, D.C.

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

1387 Fairport Rd
Suite 640
Fairport, NY 14450-2003

Phone

(585) 598-3535

NPI assigned

Mar 31, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Chiropractic

Education

New York Chiropractic College, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Derleth Chiropractic PLLCGroup PAC ID 9436207859, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Derleth Chiropractic PLLC

  • Chiropractor
  • Fairport, NY
  • NPI 1689818668
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1269993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269993600000",
    "number": "1659696771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 VALLEY BROOK DR",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144509377",
            "telephone_number": "585-598-3535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1387 FAIRPORT RD",
            "address_2": "SUITE 640",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144502003",
            "telephone_number": "585-598-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERLETH",
        "first_name": "PHILIP",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-31",
        "last_updated": "2010-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Denning, BCBA
• Christina Marie Densley, LMHC
• Lisa M Denunzio
• Meghan Depoty, LPN
• Derleth Chiropractic PLLC
• Maria Destephano
• Daniela Dethomasis, RPH
• Lauren Marie Devito, PA
• Cynthia Dilaura Devore, M.D.
• Ashley Dewitt, R.N., OTR/L

• Student in an Organized Health Care Education/Training Program in Fairport, NY
• Providers in Fairport, NY by specialty
• Student in an Organized Health Care Education/Training Program in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2010; 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.