Active NPI
William Albin Matijasic, DC
- Chiropractor
- Vermilion, OH
National Provider Identifier
1669458006
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 789
- Practice address
- 4500 Liberty Ave
Vermilion, OH 44089-1912 - Phone
- (440) 967-8077
- Fax
- (440) 967-0591
- NPI assigned
- Dec 19, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 789 | OH | Primary |
Addresses
Primary practice location
4500 Liberty Ave
Vermilion, OH 44089-1912
Mailing address
4500 Liberty Ave
Vermilion, OH 44089-1912
Phone (440) 967-8077
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080925000581 | OH | Practitioner - Chiropractic | 8729155247 | Practice locations: Vermilion, OH |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - Davenport, 1979
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
4500 Liberty Ave
Vermilion, OH 44089-1912
Phone (440) 967-8077
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 789 | OH | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134950400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1217808000000",
"number": "1669458006",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4500 LIBERTY AVE",
"city": "VERMILION",
"state": "OH",
"postal_code": "440891912",
"telephone_number": "440-967-8077",
"fax_number": "440-967-0591"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4500 LIBERTY AVE",
"city": "VERMILION",
"state": "OH",
"postal_code": "440891912",
"telephone_number": "440-967-8077",
"fax_number": "440-967-0591"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATIJASIC",
"first_name": "WILLIAM",
"middle_name": "ALBIN",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-12-19",
"last_updated": "2008-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "OH",
"license": "789",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vermilion, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2008; 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.