Individual provider Active NPI

Daniel Dino Patriarco, D.C.

  • Chiropractor
  • Liverpool, NY
National Provider Identifier
1740378611
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X005206 Issued in NY
Practice address
609 Vine St
Liverpool, NY 13088-5132
Phone
(315) 451-2222
Fax
(315) 451-2617
NPI assigned
Oct 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X005206 NY Primary

Addresses

Primary practice location

609 Vine St
Liverpool, NY 13088-5132

Mailing address

609 Vine St
Liverpool, NY 13088-5132
Phone (315) 451-2222

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080509000559 NY Practitioner - Chiropractic 6507829702 Practice locations: Camillus, NY; Liverpool, NY

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4205 Long Branch Rd
Liverpool, NY 13090-3213
Phone (315) 451-2222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X005206NYMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740378611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 VINE ST",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130885132",
            "telephone_number": "315-451-2222",
            "fax_number": "315-451-2617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 VINE ST",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130885132",
            "telephone_number": "315-451-2222",
            "fax_number": "315-451-2617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATRIARCO",
        "first_name": "DANIEL",
        "middle_name": "DINO",
        "name_prefix": "Mr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X005206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Liverpool, 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.

Verify at the official NPI Registry.