Individual provider Active NPI

David John Paoletta, DC

  • Chiropractor
  • Lindenhurst, NY
National Provider Identifier
1699868976
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X004294 Issued in NY
Practice address
236 Sunrise Hwy
Lindenhurst, NY 11757-2514
Phone
(631) 957-1717
Fax
(631) 957-4515
NPI assigned
Oct 1, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X004294 NY Primary

Addresses

Primary practice location

236 Sunrise Hwy
Lindenhurst, NY 11757-2514

Mailing address

41 Seabreeze Ave
Westhampton, NY 11977-1111
Phone (631) 288-5516

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040401000079 NY Practitioner - Chiropractic 4587656335 Practice locations: Lindenhurst, NY; Westhampton, NY

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

236 E Sunrise Hwy
Lindenhurst, NY 11757-2503
Phone (631) 957-1717

236 Sunrise Hwy
Lindenhurst, NY 11757

41 Seabreeze Ave
Westhampton, NY 11977-1111
Phone (631) 288-5516

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X004294NYMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1159660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699868976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 SEABREEZE AVE",
            "city": "WESTHAMPTON",
            "state": "NY",
            "postal_code": "119771111",
            "telephone_number": "631-288-5516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "236 SUNRISE HWY",
            "city": "LINDENHURST",
            "state": "NY",
            "postal_code": "117572514",
            "telephone_number": "631-957-1717",
            "fax_number": "631-957-4515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAOLETTA",
        "first_name": "DAVID",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X004294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lindenhurst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.