Organization Active NPI

Balanced Chiropractic Center LLC

  • Chiropractor
  • San Juan, PR
National Provider Identifier
1780241828
Registry record updated May 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
BALANCED CHIROPRACTIC CENTER LLC
Practice address
134 Ave Domenech
San Juan, PR 00918-3502
Phone
(787) 467-1017
Fax
(787) 957-6692
NPI assigned
May 23, 2019
Last updated
May 23, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2019

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

Authorized official

Name
Dr. Andre Colon Perez, DCNPI 1629215264
Title
Chiropractor / President
Phone
(787) 957-6691

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

134 Ave Domenech
San Juan, PR 00918-3502

Mailing address

134 Ave Domenech
San Juan, PR 00918-3502
Phone (787) 467-1017

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190912000153 PR Part B Supplier - Clinic/Group Practice 4082943386 Receives reassigned benefits from 2 practitioners
Practice locations: San Juan, PR

National Provider Directory

National Provider Directory

Locations

134 Calle Manuel Domenech
San Juan, PR 00918
Phone (787) 467-1017

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1558569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558569600000",
    "number": "1780241828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 AVE DOMENECH",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009183502",
            "telephone_number": "787-467-1017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 AVE DOMENECH",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009183502",
            "telephone_number": "787-467-1017",
            "fax_number": "787-957-6692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALANCED CHIROPRACTIC CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-23",
        "last_updated": "2019-05-23",
        "status": "A",
        "authorized_official_last_name": "COLON PEREZ",
        "authorized_official_first_name": "ANDRE",
        "authorized_official_title_or_position": "CHIROPRACTOR / PRESIDENT",
        "authorized_official_telephone_number": "787-957-6691",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.