Individual provider Active NPI

Jason Charles Perillo, DC

  • Chiropractor
  • Bethlehem, PA
National Provider Identifier
1699840603
Registry record updated Mar 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC009889 Issued in PA
Practice address
2299 Brodhead Rd Ste a
Bethlehem, PA 18020-8990
Phone
(610) 317-9355
Fax
(610) 317-9354
NPI assigned
Nov 22, 2006
Last updated
Mar 21, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 9214 NY
Chiropractor 111N00000X DC009889 PA Primary

Addresses

Primary practice location

2299 Brodhead Rd Ste a
Bethlehem, PA 18020-8990

Mailing address

PO Box 20704
Lehigh Valley, PA 18002-0704
Phone (610) 317-9355

Other practice location 1

4621 Fort Hamilton Pkwy
Brooklyn, NY 11219-2414
Phone (718) 435-0471

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090722000052 PA Practitioner - Chiropractic 3173542503 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2299 Brodhead Rd
Suite O
Bethlehem, PA 18020-8990
Phone (610) 317-9355

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9214NYMDChiropractor
DC009889PAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Perillo Chiropractic LLP Chiropractor CurrentSince Nov 15, 2005 Accepting new patients
Perillo Chiropractic LLP Chiropractor CurrentSince Apr 20, 2009 Accepting new patients
Boro Park Chiropractic Health Wellness PC Chiropractor Past Accepting new patients

Locations

4621 Fort Hamilton Pkwy
Brooklyn, NY 11219
Phone (718) 435-0471

2299 Brodhead Rd
Ste A
Bethlehem, PA 18020
Phone (610) 317-9355

2299 Brodhead Rd
Ste O
Bethlehem, PA 18020
Phone (484) 241-6127

Organizations & group practices 3

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": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553126400000",
    "number": "1699840603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20704",
            "city": "LEHIGH VALLEY",
            "state": "PA",
            "postal_code": "180020704",
            "telephone_number": "610-317-9355",
            "fax_number": "610-317-9354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2299 BRODHEAD RD STE A",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180208990",
            "telephone_number": "610-317-9355",
            "fax_number": "610-317-9354"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4621 Fort Hamilton Pkwy",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112192414",
            "country_code": "US",
            "telephone_number": "718-435-0471",
            "fax_number": "718-437-7518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERILLO",
        "first_name": "JASON",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-22",
        "last_updated": "2019-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "9214",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC009889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethlehem, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2019; 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.