Individual provider Active NPI

Joanna Fasulo, D.C.

  • Chiropractor
  • Ronkonkoma, NY
National Provider Identifier
1710997283
Registry record updated Mar 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X006462 Issued in NY
Practice address
4155 Veterans Memorial Hwy Ste 5
Ronkonkoma, NY 11779-6063
Phone
(516) 509-0725
NPI assigned
Aug 8, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X006462 NY Primary

Addresses

Primary practice location

4155 Veterans Memorial Hwy Ste 5
Ronkonkoma, NY 11779-6063

Mailing address

70 Wildwood Rd
Sag Harbor, NY 11963-2105
Phone (516) 509-0725

Other practice location 1

70 Wildwood Rd
Sag Harbor, NY 11963-2105
Phone (516) 509-0725

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111117000021 NY Practitioner - Chiropractic 4486828001 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Link Medical Services PLLCGroup PAC ID 7214385111, 13 clinicians

Practice addresses (Care Compare)

160 Old Country Rd
Riverhead, NY 11901-2198
Phone (631) 727-7200

4155 Veterans Memorial Hwy
Suite 5
Ronkonkoma, NY 11779-6063
Phone (516) 509-0725

680 Route 112
Suite C
Patchogue, NY 11772-1344
Phone (631) 289-3939

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X006462NYMDChiropractor
006462NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Joanna Fasulo DC PC Chiropractor CurrentSince Jan 3, 2012 Accepting new patients
Link Medical Services PLLC CurrentSince Jun 26, 2024 Accepting new patients
Within Normal Limits Physical Therapy P.C. Past Accepting new patients

Locations

680 Route 112
Ste C
Patchogue, NY 11772
Phone (631) 289-3939

160 Old Country Rd
Riverhead, NY 11901
Phone (631) 531-9400

4155 Veterans Memorial Hwy
Ste 5
Ronkonkoma, NY 11779
Phone (516) 205-6627

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773360000000",
    "number": "1710997283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 WILDWOOD RD",
            "city": "SAG HARBOR",
            "state": "NY",
            "postal_code": "119632105",
            "telephone_number": "516-509-0725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4155 VETERANS MEMORIAL HWY STE 5",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117796063",
            "telephone_number": "516-509-0725"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "70 Wildwood Rd",
            "address_purpose": "LOCATION",
            "city": "Sag Harbor",
            "state": "NY",
            "postal_code": "119632105",
            "country_code": "US",
            "telephone_number": "516-509-0725",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FASULO",
        "first_name": "JOANNA",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2026-03-13",
        "certification_date": "2026-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X006462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ronkonkoma, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2026; 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.