Active NPI
Edward J Fitzpatrick III, D.C.
- Chiropractor
- Mahopac, NY
National Provider Identifier
1699923805
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- X008010-1
- Practice address
- 89 Ellen Ave
Mahopac, NY 10541 - Phone
- (646) 331-3489
- NPI assigned
- Aug 29, 2008
- Last updated
- Aug 29, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | X008010-1 | NY | Primary |
Addresses
Primary practice location
89 Ellen Ave
Mahopac, NY 10541
Mailing address
89 Ellen Ave
Mahopac, NY 10541
Phone (646) 331-3489
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| X008010-1 | NY | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Delamere Chiropractic, P.C. | Chiropractor | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Chiropractor
- Mahopac, NY
- NPI 1063621142
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1219968000000",
"number": "1699923805",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "89 ELLEN AVE",
"city": "MAHOPAC",
"state": "NY",
"postal_code": "10541",
"telephone_number": "646-331-3489"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "89 ELLEN AVE",
"city": "MAHOPAC",
"state": "NY",
"postal_code": "10541",
"telephone_number": "646-331-3489"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FITZPATRICK",
"first_name": "EDWARD",
"middle_name": "J",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-08-29",
"last_updated": "2008-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NY",
"license": "X008010-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Mahopac, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.