Individual provider Active NPI

Barry Mark Triestman, D.C.

  • Nutrition Chiropractor
  • Truckee, CA
National Provider Identifier
1669461885
Registry record updated May 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition ChiropractorTaxonomy code 111NN1001X
License
DC 25940 Issued in CA
Practice address
11464 E Ridge Rd
Truckee, CA 96161-1716
Phone
(530) 412-0072
Fax
(530) 550-1622
NPI assigned
Oct 20, 2005
Last updated
May 10, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Chiropractor 111NN1001X DC 25940 CA Primary

Addresses

Primary practice location

11464 E Ridge Rd
Truckee, CA 96161-1716

Mailing address

11464 E Ridge Rd
Truckee, CA 96161-1716
Phone (530) 550-1688

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100820000746 CA Practitioner - Chiropractic 1254465651 Practice locations: Truckee, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11464 E Ridge Rd
Truckee, CA 96161-1716
Phone (530) 550-1688

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC 25940CAMDNutrition Chiropractor
25940CAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589068800000",
    "number": "1669461885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11464 E RIDGE RD",
            "city": "TRUCKEE",
            "state": "CA",
            "postal_code": "961611716",
            "telephone_number": "530-550-1688",
            "fax_number": "530-550-1622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11464 E RIDGE RD",
            "city": "TRUCKEE",
            "state": "CA",
            "postal_code": "961611716",
            "telephone_number": "530-412-0072",
            "fax_number": "530-550-1622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIESTMAN",
        "first_name": "BARRY",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-20",
        "last_updated": "2020-05-10",
        "certification_date": "2020-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "CA",
            "license": "DC 25940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Truckee, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2020; 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.