Individual provider Active NPI

Eugene Rinaldi Deminico, D.C.

  • Sports Physician Chiropractor
  • Pittston, PA
National Provider Identifier
1730192535
Registry record updated Nov 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
DC001908L Issued in PA
Practice address
84 S Main St
Pittston, PA 18640-1713
Phone
(570) 654-0036
Fax
(570) 654-7890
NPI assigned
Aug 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X DC001908L PA Primary

Addresses

Primary practice location

84 S Main St
Pittston, PA 18640-1713

Mailing address

84 S Main St
Pittston, PA 18640-1713
Phone (570) 654-0036

Other identifiers 1

IdentifierTypeStateIssuer
0006310910001MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120106000676 PA Practitioner - Chiropractic 2365618675 Practice locations: Pittston, PA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

84 S Main St
Pittston, PA 18640-1713
Phone (570) 654-0036

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC001908LPAMDSports Physician Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Rhyan Mercado DC PastSince May 16, 2021 Accepting new patients

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": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321574400000",
    "number": "1730192535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "84 S MAIN ST",
            "city": "PITTSTON",
            "state": "PA",
            "postal_code": "186401713",
            "telephone_number": "570-654-0036",
            "fax_number": "570-654-7890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "84 S MAIN ST",
            "city": "PITTSTON",
            "state": "PA",
            "postal_code": "186401713",
            "telephone_number": "570-654-0036",
            "fax_number": "570-654-7890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMINICO",
        "first_name": "EUGENE",
        "middle_name": "RINALDI",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2011-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "PA",
            "license": "DC001908L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0006310910001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittston, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2011; 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.