Individual provider Active NPI

Bryan T Ruocco, DC

  • Chiropractor
  • Marblehead, MA
National Provider Identifier
1750362273
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3020 Issued in MA
Practice address
111 Pleasant St
Marblehead, MA 01945-2339
Phone
(781) 631-3333
Fax
(781) 631-3339
NPI assigned
Nov 10, 2005
Last updated
Mar 14, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3020 MA Primary

Addresses

Primary practice location

111 Pleasant St
Marblehead, MA 01945-2339

Mailing address

111 Pleasant St
Marblehead, MA 01945-2339
Phone (781) 631-3333

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051104000123 MA Practitioner - Chiropractic 4284650193 Practice locations: Marblehead, MA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

111 Pleasant St
Marblehead, MA 01945-2339
Phone (781) 631-3333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3020MAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Seaport Chiropractic PastSince Jan 1, 1990 Accepting new patients
Chiropractic Works PLLC Chiropractor PastSince Dec 16, 2012 Accepting new patients

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": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1750362273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 PLEASANT ST",
            "city": "MARBLEHEAD",
            "state": "MA",
            "postal_code": "019452339",
            "telephone_number": "781-631-3333",
            "fax_number": "781-631-3339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 PLEASANT ST",
            "city": "MARBLEHEAD",
            "state": "MA",
            "postal_code": "019452339",
            "telephone_number": "781-631-3333",
            "fax_number": "781-631-3339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUOCCO",
        "first_name": "BRYAN",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-10",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "3020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marblehead, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2025; 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.