Roberta Lynn Peets, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

009368 Issued in NY

Practice address

100 W Suffolk Ave Unit G
Central Islip, NY 11722-2155

Phone

(631) 993-5400

NPI assigned

Oct 30, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Dr. Roberta Lynn Fiordalisi Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Island Care Chiropractic of Suffolk PC

  • Chiropractor
  • Central Islip, NY
  • NPI 1033976147
  NPD Authorized official
• Core Chiropractic Rehabilitation PC

  • Chiropractor
  • Port Jefferson Station, NY
  • NPI 1518148089
  NPD (past)

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

{
    "created_epoch": "1193702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709596800000",
    "number": "1699954396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77A RT 25A",
            "city": "ROCKY POINT",
            "state": "NY",
            "postal_code": "117788881",
            "telephone_number": "631-849-6363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W SUFFOLK AVE UNIT G",
            "city": "CENTRAL ISLIP",
            "state": "NY",
            "postal_code": "117222155",
            "telephone_number": "631-993-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEETS",
        "first_name": "ROBERTA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-30",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X009368",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "009368",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1538586177",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1033976147",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1518148089",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROBERTA",
            "last_name": "FIORDALISI",
            "middle_name": "LYNN",
            "prefix": "DR.",
            "credential": "DC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Veronica Alexis Patrick
• Nativity Stephanie Patterson, LPN
• Patricia Paul, LPN
• William Joseph Peruso, DDS
• Eileen M. Petre, MS
• Pick Your Pathway Inc
• Bryanna Miracle Picton
• Lutesia Pierre

• Chiropractor in Central Islip, NY
• Providers in Central Islip, NY by specialty
• Chiropractor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.