Individual provider Active NPI

Richard A Dark, DC

  • Orthopedic Chiropractor
  • Farmingville, NY
National Provider Identifier
1710069398
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic ChiropractorTaxonomy code 111NX0800X
License
X004836-1 Issued in NY
Practice address
1 Mount McKinley Ave
Farmingville, NY 11738-2107
Phone
(631) 736-0900
Fax
(631) 736-3842
NPI assigned
Oct 20, 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
Orthopedic Chiropractor 111NX0800X X004836-1 NY Primary

Addresses

Primary practice location

1 Mount McKinley Ave
Farmingville, NY 11738-2107

Mailing address

1 Mount McKinley Ave
Farmingville, NY 11738-2107
Phone (631) 736-0900

Other identifiers 8

IdentifierTypeStateIssuer
11-2946756OtherCALANDMARK
320250OtherCAAMERICAN SPECIALTY HEALTH
76833OtherNYAETNA
8983718-00OtherCTCIGNA
0017091OtherNYGHI
115137OtherNYMPN
1280677OtherNYUNITED HEALTH CARE
P647932OtherNYOXFORD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110202000080 NY Practitioner - Chiropractic 0143400556 Practice locations: Farmingville, NY

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1 Mount McKinley Ave
Farmingville, NY 11738-2107
Phone (631) 736-0900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X004836-1NYMDOrthopedic Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Care Associates, LLP Past Accepting new patients
Prohealth Care Associates LLP PastSince Aug 15, 2011 Accepting new patients

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": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710069398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MOUNT MCKINLEY AVE",
            "city": "FARMINGVILLE",
            "state": "NY",
            "postal_code": "117382107",
            "telephone_number": "631-736-0900",
            "fax_number": "631-736-3842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MOUNT MCKINLEY AVE",
            "city": "FARMINGVILLE",
            "state": "NY",
            "postal_code": "117382107",
            "telephone_number": "631-736-0900",
            "fax_number": "631-736-3842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DARK",
        "first_name": "RICHARD",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "NY",
            "license": "X004836-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LANDMARK",
            "identifier": "11-2946756",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN SPECIALTY HEALTH",
            "identifier": "320250",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "76833",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "8983718-00",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0017091",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MPN",
            "identifier": "115137",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "1280677",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P647932",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmingville, 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.