Individual provider Active NPI

Matthew Caulfield, DC

  • Chiropractor
  • St Petersburg, FL
National Provider Identifier
1669998407
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH12179 Issued in FL
Practice address
3600 1St Ave N
St Petersburg, FL 33713-8407
Phone
(727) 327-4522
Fax
(727) 327-8069
NPI assigned
Aug 14, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH12179 FL Primary

Addresses

Primary practice location

3600 1St Ave N
St Petersburg, FL 33713-8407

Mailing address

3600 1St Ave N
St Petersburg, FL 33713-8407
Phone (727) 327-4522

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240116002443 WA Practitioner - Chiropractic 2062864036 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Haley Chiropractic P SGroup PAC ID 0143215475, 3 clinicians

Practice addresses (Care Compare)

1919 N Pearl St
Suite A4
Tacoma, WA 98406-2456
Phone (253) 761-0930

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH12179FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Haley Chiropractic P.S. Chiropractor CurrentSince Aug 1, 2024 Accepting new patients
Petett Chiropractic Clinic, Inc. PastSince Jan 2, 2024 Accepting new patients

Locations

1919 N Pearl St
Ste A4
Tacoma, WA 98406
Phone (253) 761-0930

Organizations & group practices 2

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": "1502668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1669998407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 1ST AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337138407",
            "telephone_number": "727-327-4522",
            "fax_number": "727-327-8069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 1ST AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337138407",
            "telephone_number": "727-327-4522",
            "fax_number": "727-327-8069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAULFIELD",
        "first_name": "MATTHEW",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-14",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH12179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.