Individual provider Active NPI

Diego A Marmanillo, D.C.

  • Chiropractor
  • Middletown, NY
National Provider Identifier
1770806432
Registry record updated Oct 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
011789 Issued in NY
Practice address
450 E Main St
Middletown, NY 10940-2577
Phone
(845) 344-0444
Fax
(845) 344-0456
NPI assigned
Mar 10, 2010
Last updated
Oct 30, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 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 011789 NY Primary

Addresses

Primary practice location

450 E Main St
Middletown, NY 10940-2577

Mailing address

35 Red Barn Rd
Pine Bush, NY 12566-7457
Phone (845) 807-3768

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201209000858 NY Practitioner - Chiropractic 7012329444 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

450 E Main St
Middletown, NY 10940-2578
Phone (845) 344-0444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
011789NYMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Middletown Health Wellness Chiropractic PC Chiropractor CurrentSince May 8, 2025 Accepting new patients

Locations

450 E Main St
Middletown, NY 10940
Phone (845) 343-5505

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": "1268179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761782400000",
    "number": "1770806432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 RED BARN RD",
            "city": "PINE BUSH",
            "state": "NY",
            "postal_code": "125667457",
            "telephone_number": "845-807-3768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 E MAIN ST",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109402577",
            "telephone_number": "845-344-0444",
            "fax_number": "845-344-0456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARMANILLO",
        "first_name": "DIEGO",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-10",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "011789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 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.