Individual provider Active NPI

Sudeep Chawla, D.C.

  • Chiropractor
  • Danvers, MA
National Provider Identifier
1689926214
Registry record updated May 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3585 Issued in MA
Practice address
435 Newbury St Ste 208
Danvers, MA 01923-1065
Phone
(617) 334-5002
Fax
(978) 208-0494
NPI assigned
Oct 5, 2012
Last updated
May 2, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH-10718 FL
Chiropractor 111N00000X 3585 MA Primary

Addresses

Primary practice location

435 Newbury St Ste 208
Danvers, MA 01923-1065

Mailing address

125 Palomino Dr
North Andover, MA 01845-3379
Phone (517) 420-2435

Other practice location 1

42 Eastern Ave
Malden, MA 02148-5014
Phone (517) 420-2435

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220811000187 MA Practitioner - Chiropractic 8628223328 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

435 Newbury St
Suite 208
Danvers, MA 01923-1065
Phone (617) 334-5002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3385MAMDPsychologist
CH-10718FLMDChiropractor
3585MAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Chawla Chiropractic PLLC Chiropractor CurrentSince May 1, 2022 Accepting new patients
Chiro-Dynamics Spine & Joints Rehab LLC Chiropractor PastSince Jun 22, 2021 Accepting new patients

Locations

435 Newbury St
Ste 208
Danvers, MA 01923
Phone (617) 334-5002

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1349395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651449600000",
    "number": "1689926214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 PALOMINO DR",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "018453379",
            "telephone_number": "517-420-2435",
            "fax_number": "978-208-0494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 NEWBURY ST STE 208",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019231065",
            "telephone_number": "617-334-5002",
            "fax_number": "978-208-0494"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "42 Eastern Ave",
            "address_purpose": "LOCATION",
            "city": "Malden",
            "state": "MA",
            "postal_code": "021485014",
            "country_code": "US",
            "telephone_number": "517-420-2435",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAWLA",
        "first_name": "SUDEEP",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-05",
        "last_updated": "2022-05-02",
        "certification_date": "2022-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH-10718",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "3585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danvers, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 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.