Individual provider Active NPI

Aaron M Selfridge, D.C.

  • Chiropractor
  • Hyannis, MA
National Provider Identifier
1679629505
Registry record updated Jun 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2730 Issued in MA
Practice address
1336 Phinneys LN Unit 4
Hyannis, MA 02601
Phone
(508) 790-9590
Fax
(508) 790-9591
NPI assigned
Jan 25, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2730 MA Primary

Addresses

Primary practice location

1336 Phinneys LN Unit 4
Hyannis, MA 02601

Mailing address

1336 Phinneys LN Unit 4
Hyannis, MA 02601-1890
Phone (508) 790-9590

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060504000654 MA Practitioner - Chiropractic 0345250304 Practice locations: Hyannis, MA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1336 Phinneys LN
Suite 4
Hyannis, MA 02601-1890
Phone (508) 790-9590

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2730MAMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528934400000",
    "number": "1679629505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1336 PHINNEYS LN UNIT 4",
            "city": "HYANNIS",
            "state": "MA",
            "postal_code": "026011890",
            "telephone_number": "508-790-9590",
            "fax_number": "508-790-9591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1336 PHINNEYS LN UNIT 4",
            "city": "HYANNIS",
            "state": "MA",
            "postal_code": "02601",
            "telephone_number": "508-790-9590",
            "fax_number": "508-790-9591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELFRIDGE",
        "first_name": "AARON",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2018-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "2730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hyannis, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2018; 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.