Individual provider Active NPI

Thadeus J Brandt, DC

  • Chiropractor
  • Callicoon, NY
National Provider Identifier
1700256906
Registry record updated Dec 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
013375 Issued in NY
Practice address
20 Gregory St
Callicoon, NY 12723-5322
Phone
(570) 251-1807
Fax
(585) 625-0569
NPI assigned
Sep 30, 2015
Last updated
Dec 8, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 013375 NY Primary
Chiropractor 111N00000X DC011077 PA
Rehabilitation Chiropractor 111NR0400X AJ010847 PA

Addresses

Primary practice location

20 Gregory St
Callicoon, NY 12723-5322

Mailing address

PO Box 492
Callicoon, NY 12723-0492
Phone (570) 251-1807

Other practice location 1

90 Main St
Livingston Manor, NY 12758-5144
Phone (570) 251-1807

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221207000783 NY Practitioner - Chiropractic 0244508760 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2015
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

20 Gregory St
Callicoon, NY 12723-5322
Phone (845) 428-4885

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC011077PAMDChiropractor
AJ010847PAMDRehabilitation Chiropractor
013375NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Brandt Chiropractic and Wellness, PLLC Chiropractor CurrentSince May 1, 2017 Accepting new patients
Callicoon Chiropractic PC Chiropractor CurrentSince Sep 9, 2022 Accepting new patients

Locations

1439 Monroe Ave
Ste 5
Dunmore, PA 18509
Phone (570) 871-4915

Organizations & group practices 2

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": "1443571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765152000000",
    "number": "1700256906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 492",
            "city": "CALLICOON",
            "state": "NY",
            "postal_code": "127230492",
            "telephone_number": "570-251-1807",
            "fax_number": "585-625-0569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 GREGORY ST",
            "city": "CALLICOON",
            "state": "NY",
            "postal_code": "127235322",
            "telephone_number": "570-251-1807",
            "fax_number": "585-625-0569"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "90 Main St",
            "address_purpose": "LOCATION",
            "city": "Livingston Manor",
            "state": "NY",
            "postal_code": "127585144",
            "country_code": "US",
            "telephone_number": "570-251-1807",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRANDT",
        "first_name": "THADEUS",
        "middle_name": "J",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-09-30",
        "last_updated": "2025-12-08",
        "certification_date": "2025-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "013375",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC011077",
            "primary": false
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "PA",
            "license": "AJ010847",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Callicoon, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2025; 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.