Mark Robert Bellucci, D.C.
Individual provider Active NPI Chiropractor · Enfield, CT
NPI 1790700979 · NPPES record last updated Mar 2, 2017
Key facts
- NPI
- 1790700979
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 000701 (CT)
- Practice address
- 155 Hazard Ave
Enfield, CT 06082-4580 - Phone
- (860) 763-4848
- Fax
- (860) 763-4850
- NPI assigned
- Jul 12, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- National College of Chiropractic, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
155 Hazard Ave
Enfield, CT 06082-4580
155 Hazard Ave
Suite 3
Enfield, CT 06082-4586
Phone (860) 763-4848
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101021000405 | CT | Practitioner - Chiropractic | 7810180999 | Practice locations: Enfield, CT |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000701 | CT | MD | Professional Counselor |
Interoperability endpoints
- mark@bcc0027.direct.chirotouch.md
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 000701 | CT | Yes |
Addresses
Primary practice location
155 Hazard Ave
Enfield, CT 06082-4580
Mailing address
155 Hazard Ave
Enfield, CT 06082-4580
Phone (860) 763-4848
Other providers in Enfield, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 2, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.