Active NPI
Michael Anthony Pezza, D.C.
- Chiropractor
- Johnston, RI
National Provider Identifier
1780901363
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DCP00593
- Practice address
- 1 Harding Ave
Johnston, RI 02919-5010 - Phone
- (401) 330-9037
- NPI assigned
- Apr 22, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DCP00593 | RI | Primary |
Addresses
Primary practice location
1 Harding Ave
Johnston, RI 02919-5010
Mailing address
1 Harding Ave
Johnston, RI 02919-5010
Phone (401) 330-9037
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in RI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170803000287 | RI | Practitioner - Chiropractic | 9830460211 | Practice locations: Cranston, RI |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Other, 2009
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
960 Reservoir Ave
Suite 12
Cranston, RI 02910-4447
Phone (401) 228-3091
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DCP00593 | RI | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1271894400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1271894400000",
"number": "1780901363",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 HARDING AVE",
"city": "JOHNSTON",
"state": "RI",
"postal_code": "029195010",
"telephone_number": "401-330-9037"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 HARDING AVE",
"city": "JOHNSTON",
"state": "RI",
"postal_code": "029195010",
"telephone_number": "401-330-9037"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEZZA",
"first_name": "MICHAEL",
"middle_name": "ANTHONY",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-04-22",
"last_updated": "2010-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "RI",
"license": "DCP00593",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Johnston, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2010; 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.