Active NPI
Lawrence Otto Mietzelfeld Jr., D.C.
- Chiropractor
- Oneonta, NY
National Provider Identifier
1710087408
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- X003096
- Practice address
- 55 S Main St
Oneonta, NY 13820-2516 - Phone
- (607) 432-4330
- NPI assigned
- Sep 23, 2006
- Sex
- Male
- 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 | X003096 | NY | Primary |
Addresses
Primary practice location
55 S Main St
Oneonta, NY 13820-2516
Mailing address
55 S Main St
Oneonta, NY 13820-2516
Phone (607) 432-4330
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| C03096-7 | Other | NY | WORKERS' COMPENSATION |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080225000485 | NY | Practitioner - Chiropractic | 2466536800 | Practice locations: Oneonta, NY |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Los Angeles College of Chiropractic, 1981
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
10 Market St
Suite 6
Oneonta, NY 13820-2626
Phone (607) 432-4330
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| X003096 | NY | MD | Chiropractor |
| 003096 | NY | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158969600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1710087408",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55 S MAIN ST",
"city": "ONEONTA",
"state": "NY",
"postal_code": "138202516",
"telephone_number": "607-432-4330"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 S MAIN ST",
"city": "ONEONTA",
"state": "NY",
"postal_code": "138202516",
"telephone_number": "607-432-4330"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIETZELFELD",
"first_name": "LAWRENCE",
"middle_name": "OTTO",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NY",
"license": "X003096",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WORKERS' COMPENSATION",
"identifier": "C03096-7",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oneonta, 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.