Individual provider Active NPI

Angelo M Biase, DC

  • Chiropractor
  • Patchogue, NY
National Provider Identifier
1750474946
Registry record updated Nov 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X0084991 Issued in NY
Practice address
105 Medford Ave
Patchogue, NY 11772-1223
Phone
(631) 289-6767
Fax
(631) 289-6790
NPI assigned
Oct 2, 2006
Last updated
Nov 15, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X0084991 NY Primary

Addresses

Primary practice location

105 Medford Ave
Patchogue, NY 11772-1223

Mailing address

105 Medford Ave
Patchogue, NY 11772-1223
Phone (631) 289-6767

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101230000059 NY Practitioner - Chiropractic 5597819540 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Great South Bay Chiropractic OfficeGroup PAC ID 9436685112, 2 clinicians

Practice addresses (Care Compare)

105 Medford Ave
Patchogue, NY 11772-1223
Phone (631) 289-6767

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
008499NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Great South Bay Chiropractic Office Chiropractor CurrentSince Sep 23, 2024 Accepting new patients

Locations

105 Route 112
Patchogue, NY 11772
Phone (631) 289-6767

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, 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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731628800000",
    "number": "1750474946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 MEDFORD AVE",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117721223",
            "telephone_number": "631-289-6767",
            "fax_number": "631-289-6790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 MEDFORD AVE",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117721223",
            "telephone_number": "631-289-6767",
            "fax_number": "631-289-6790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIASE",
        "first_name": "ANGELO",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X0084991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Patchogue, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2024; 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.