David Marc Petrosino X, D.C.

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

006097 Issued in NY

Practice address

5 Hamilton Ave # 1
Auburn, NY 13021-4819

Phone

(315) 252-2828

Fax

(315) 255-1965

NPI assigned

Sep 25, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790885044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 HAMILTON AVE # 1",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130214819",
            "telephone_number": "315-252-2828",
            "fax_number": "315-255-1965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 HAMILTON AVE # 1",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130214819",
            "telephone_number": "315-252-2828",
            "fax_number": "315-255-1965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETROSINO",
        "first_name": "DAVID",
        "middle_name": "MARC",
        "name_prefix": "Dr.",
        "name_suffix": "X",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "NY",
            "license": "006097",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MPN EMPIRE PLAN",
            "identifier": "816181",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS  WORKER'S COMPENSATIO",
            "identifier": "CO-6097-2",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LISCENCE NUMBER",
            "identifier": "006097",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christy Lee Perham
• Andrea F Perkins, CCC-SLP
• Jeannine Peterson, LMSW
• Jean Petrosino Winne, LCSW
• Claire Petrosino, PT
• Michael John Petrosino, DO
• Allison Pflug, PA
• Shelaina Denise Pflug, LMSW
• Molly Eileen Phelps, LMSW
• Susan Phillips-Coe

• Sports Physician Chiropractor in Auburn, NY
• Providers in Auburn, NY by specialty
• Sports Physician Chiropractor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.