Active NPI
Ellen E. Matuszak, DC
- Chiropractor
- Ithaca, NY
National Provider Identifier
1700945334
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 10155
- Practice address
- 215 N Cayuga St
Ithaca, NY 14850-4329 - Phone
- (607) 273-8110
- Fax
- (607) 273-8110
- NPI assigned
- Dec 8, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 | 10155 | NY | Primary |
Addresses
Primary practice location
215 N Cayuga St
Ithaca, NY 14850-4329
Mailing address
215 N Cayuga St
Ithaca, NY 14850-4329
Phone (607) 273-8110
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040511000183 | NY | Practitioner - Chiropractic | 0446249825 | Practice locations: Trumansburg, NY |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- New York Chiropractic College, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1891 Route 96
Trumansburg, NY 14886-9143
Phone (607) 387-8110
1891 RT
Suite 96
Trumansburg, NY 14886-9143
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10155 | NY | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165536000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1700945334",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "215 N CAYUGA ST",
"city": "ITHACA",
"state": "NY",
"postal_code": "148504329",
"telephone_number": "607-273-8110",
"fax_number": "607-273-8110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 N CAYUGA ST",
"city": "ITHACA",
"state": "NY",
"postal_code": "148504329",
"telephone_number": "607-273-8110",
"fax_number": "607-273-8110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATUSZAK",
"first_name": "ELLEN",
"middle_name": "E.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NY",
"license": "10155",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ithaca, NY
- Terry Kevin Mattice, PTA
- Patricia A Mattingly, PNP
- Annemarie Cahill Mattison, MSW, LCSW-R
- Anna Matusiewicz, M.D
- Daniel Edward Matusiewicz, TH.M.
- Marie-Lucile Mauboussin, MSW, LMSW
- Luis Thelmo Mauleon Jr., D.D.S.
- Jonathan Frank Mauser, MD
- Mavis NG DMD Comprehensive Dentistry PLLC
- Eileen June Maxwell, LCSW
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.