Individual provider Active NPI

Daniel J. Serpentelli III, DC

  • Chiropractor
  • Bradenton, FL
National Provider Identifier
1720116916
Registry record updated Oct 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH5589 Issued in FL
Practice address
3806 Manatee Ave West
Suite 100
Bradenton, FL 34205
Phone
(941) 739-2225
Fax
(941) 753-6821
NPI assigned
Mar 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH5589 FL Primary

Addresses

Primary practice location

3806 Manatee Ave West
Suite 100
Bradenton, FL 34205

Mailing address

3806 Manatee Ave West
Suite 100
Bradenton, FL 34205
Phone (941) 739-2225

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050919000685 FL Practitioner - Chiropractic 4981638095 Reassigns benefits to 1 organization

Care Compare profile

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

Practice addresses (Care Compare)

3806 Manatee Ave W
Suite 100
Bradenton, FL 34205-1714
Phone (941) 739-2225

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH5589FLMDChiropractor

Organizations & group practices 1

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": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570752000000",
    "number": "1720116916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3806 MANATEE AVE WEST",
            "address_2": "SUITE 100",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "34205",
            "telephone_number": "941-739-2225",
            "fax_number": "941-753-6821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3806 MANATEE AVE WEST",
            "address_2": "SUITE 100",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "34205",
            "telephone_number": "941-739-2225",
            "fax_number": "941-753-6821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERPENTELLI",
        "first_name": "DANIEL",
        "middle_name": "J.",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-01",
        "last_updated": "2019-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH5589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2019; 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.