Individual provider Active NPI

Michael Anthony Muffoletto, D.C.

  • Chiropractor
  • Fountain Valley, CA
National Provider Identifier
1720271745
Registry record updated May 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
18556 Issued in CA
Practice address
17922 Magnolia St
Fountain Valley, CA 92708-5039
Phone
(714) 964-5100
Fax
(714) 964-5126
NPI assigned
Aug 22, 2007
Last updated
May 6, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 18556 CA Primary

Addresses

Primary practice location

17922 Magnolia St
Fountain Valley, CA 92708-5039

Mailing address

17922 Magnolia St
Fountain Valley, CA 92708-5039
Phone (714) 964-5100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150803000489 CA Practitioner - Chiropractic 9537472303 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Los Angeles College of Chiropractic, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

19171 Magnolia St
Suite 13
Huntington Beach, CA 92646-2244
Phone (714) 964-5100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18556CAMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Muffoletto Chiropractic Inc Chiropractor CurrentSince May 4, 2015 Accepting new patients
Trigo Health Chiropractic Inc. Chiropractor PastSince May 4, 2015 Accepting new patients

Locations

17922 Magnolia St
Fountain Vly, CA 92708
Phone (714) 887-7009

19171 Magnolia St
Ste 13
Huntington Beach, CA 92646
Phone (714) 378-4893

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": "1187740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430870400000",
    "number": "1720271745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17922 MAGNOLIA ST",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927085039",
            "telephone_number": "714-964-5100",
            "fax_number": "714-964-5126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17922 MAGNOLIA ST",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927085039",
            "telephone_number": "714-964-5100",
            "fax_number": "714-964-5126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUFFOLETTO",
        "first_name": "MICHAEL",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-22",
        "last_updated": "2015-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "18556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2015; 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.