Derleth Chiropractic PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

011622 Issued in NY

Legal business name

DERLETH CHIROPRACTIC PLLC

Practice address

1387 Fairport Rd
Suite 640
Fairport, NY 14450-2003

Phone

(585) 598-3535

Fax

(585) 598-3534

NPI assigned

Apr 22, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Paula Mary Derleth, D.C.NPI 1366602369

Title

Owner/Chiropractor

Phone

(585) 598-3535

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 5

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

• Paula Mary Derleth, D.C.

  • Student in an Organized Health Care Education/Training Program
  • Penfield, NY
  • NPI 1366602369
  Medicare reassignment Care Compare group NPD Authorized official
• Philip John Derleth, D.C.

  • Student in an Organized Health Care Education/Training Program
  • Fairport, NY
  • NPI 1659696771
  Medicare reassignment Care Compare group NPD
• Nicole Bondi, LCSW-R

  • Clinical Social Worker
  • Rochester, NY
  • NPI 1851827182
  NPD (past)
• Emily S Queenan, M.D

  • Family Medicine Physician
  • Rochester, NY
  • NPI 1720001795
  NPD (past)
• Laurel A Seifert, LCSW-R

  • Clinical Social Worker
  • Fairport, NY
  • NPI 1326106907
  NPD (past)

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

{
    "created_epoch": "1240358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240358400000",
    "number": "1689818668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1387 FAIRPORT RD",
            "address_2": "SUITE 640",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144502003",
            "telephone_number": "585-598-3535",
            "fax_number": "585-598-3534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1387 FAIRPORT RD",
            "address_2": "SUITE 640",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144502003",
            "telephone_number": "585-598-3535",
            "fax_number": "585-598-3534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERLETH CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-22",
        "last_updated": "2009-04-22",
        "status": "A",
        "authorized_official_last_name": "DERLETH",
        "authorized_official_first_name": "PAULA",
        "authorized_official_middle_name": "MARY",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "585-598-3535",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "011622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denise Mantione, M.S.CCC-SLP PLLC Pediatric Speech-Language Pathology
• Courtney Denning, BCBA
• Christina Marie Densley, LMHC
• Lisa M Denunzio
• Meghan Depoty, LPN
• Philip John Derleth, D.C.
• Maria Destephano
• Daniela Dethomasis, RPH
• Lauren Marie Devito, PA
• Cynthia Dilaura Devore, M.D.

• Chiropractor in Fairport, NY
• Providers in Fairport, NY by specialty
• Chiropractor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 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.