Organization Active NPI

Lisa a. Maffucci, D.C., PLLC

  • Chiropractor
  • Kingston, NY
National Provider Identifier
1669701165
Registry record updated Dec 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X010080 Issued in NY
Legal business name
LISA A. MAFFUCCI, D.C., PLLC
Practice address
187 Pine St
Kingston, NY 12401-4527
Phone
(845) 338-2084
Fax
(845) 334-9343
NPI assigned
Dec 11, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2009

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

Authorized official

Name
Dr. Lisa A. Maffucci, D.C.NPI 1689863292
Title
Owner/Chiropractor
Phone
(845) 338-2084

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X X010080 NY Primary

Addresses

Primary practice location

187 Pine St
Kingston, NY 12401-4527

Mailing address

187 Pine St
Kingston, NY 12401-4527
Phone (845) 338-2084

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100108000621 NY Part B Supplier - Clinic/Group Practice 0042351355 Receives reassigned benefits from 1 practitioner
Practice locations: Red Hook, NY

National Provider Directory

National Provider Directory

Locations

187 Pine St
Kingston, NY 12401
Phone (845) 334-9340

102 W Market St
#102
Red Hook, NY 12571

102 W Market St
Red Hook, NY 12571
Phone (845) 758-9871

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1260489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260489600000",
    "number": "1669701165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "187 PINE ST",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124014527",
            "telephone_number": "845-338-2084",
            "fax_number": "845-334-9343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "187 PINE ST",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124014527",
            "telephone_number": "845-338-2084",
            "fax_number": "845-334-9343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA A. MAFFUCCI, D.C., PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-11",
        "last_updated": "2009-12-11",
        "status": "A",
        "authorized_official_last_name": "MAFFUCCI",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "845-338-2084",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X010080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2009; 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.