Individual provider Active NPI

Anthony Dicostanzo, DC

  • Chiropractor
  • Garden City, NY
National Provider Identifier
1699864827
Registry record updated Mar 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X008415 Issued in NY
Practice address
350 Old Country Rd
Suite 102
Garden City, NY 11530-1749
Phone
(516) 248-0103
Fax
(516) 248-4661
NPI assigned
Oct 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X008415 NY Primary

Addresses

Primary practice location

350 Old Country Rd
Suite 102
Garden City, NY 11530-1749

Mailing address

350 Old Country Rd
Suite 102
Garden City, NY 11530-1749
Phone (516) 248-0103

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050222000790 NY Practitioner - Chiropractic 0749233435 Practice locations: Garden City, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X008415NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Miguel Vargas MD PC Past Accepting new patients

Organizations & group practices 1

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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205971200000",
    "number": "1699864827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 OLD COUNTRY RD",
            "address_2": "SUITE 102",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115301749",
            "telephone_number": "516-248-0103",
            "fax_number": "516-248-4661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 OLD COUNTRY RD",
            "address_2": "SUITE 102",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115301749",
            "telephone_number": "516-248-0103",
            "fax_number": "516-248-4661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICOSTANZO",
        "first_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2008-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X008415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2008; 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.