Individual provider Active NPI

Vincent Carl Siraguso, D.C.

  • Chiropractor
  • Liberty, MO
National Provider Identifier
1801015243
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6282 Issued in MO
Practice address
1201 Landmark Ave
Liberty, MO 64068-1050
Phone
(816) 792-1766
Fax
(816) 792-1201
NPI assigned
Apr 24, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 6282 MO Primary

Addresses

Primary practice location

1201 Landmark Ave
Liberty, MO 64068-1050

Mailing address

5305 NE 70TH St
Kansas City, MO 64119-5605
Phone (816) 215-7619

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080103000649 MO Practitioner - Chiropractic 6103906151 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Kansas City, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

113 Blue Jay Dr
Suite 106
Liberty, MO 64068-1963
Phone (816) 415-2900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6282MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Siraguso Chiropractic Inc. Chiropractor CurrentSince Oct 15, 2007 Accepting new patients

Locations

113 Blue Jay Dr
Ste 106
Liberty, MO 64068
Phone (816) 415-2400

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801015243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5305 NE 70TH ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641195605",
            "telephone_number": "816-215-7619",
            "fax_number": "816-792-1201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 LANDMARK AVE",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640681050",
            "telephone_number": "816-792-1766",
            "fax_number": "816-792-1201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIRAGUSO",
        "first_name": "VINCENT",
        "middle_name": "CARL",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "6282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty, MO

Sources for this page

  • 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.