Individual provider Active NPI

Nicholas Leblanc

  • Chiropractor
  • Glastonbury, CT
National Provider Identifier
1750153938
Registry record updated Oct 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
002194 Issued in CT
Practice address
10 Commerce St Ste B
Glastonbury, CT 06033-4802
Phone
(860) 430-9116
NPI assigned
Oct 23, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 002194 CT Primary

Addresses

Primary practice location

10 Commerce St Ste B
Glastonbury, CT 06033-4802

Mailing address

693 Orange St Apt 403
New Haven, CT 06511-2554

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240528003446 CT Practitioner - Chiropractic 7113369794 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10 Commerce St
Suite B
Glastonbury, CT 06033-4802
Phone (860) 430-9116

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002194CTMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Chiromark, LLC Chiropractor CurrentSince Oct 29, 2023 Accepting new patients
Vivo Chiropractic Glastonbury LLC Chiropractor CurrentSince Feb 11, 2024 Accepting new patients

Locations

10 Commerce St
Ste B
Glastonbury, CT 06033
Phone (860) 430-9116

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1698019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1750153938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "693 ORANGE ST APT 403",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065112554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 COMMERCE ST STE B",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060334802",
            "telephone_number": "860-430-9116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBLANC",
        "first_name": "NICHOLAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-10-23",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CT",
            "license": "002194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glastonbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2023; 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.