Individual provider Active NPI

Paul Athony Forakis, D.C.

  • Chiropractor
  • Modesto, CA
National Provider Identifier
1801888284
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
15466 Issued in CA
Practice address
1316 Coffee Rd
BLDG. a-2
Modesto, CA 95355-3191
Phone
(209) 527-3557
Fax
(209) 527-6739
NPI assigned
Aug 22, 2005
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 15466 CA Primary

Addresses

Primary practice location

1316 Coffee Rd
BLDG. a-2
Modesto, CA 95355-3191

Mailing address

1316 Coffee Rd
BLDG. a-2
Modesto, CA 95355-3191
Phone (209) 527-3557

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060103000663 CA Practitioner - Chiropractic 3375565419 Practice locations: Modesto, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1316 Coffee Rd
Suite A2
Modesto, CA 95355-3191
Phone (209) 527-3557

1316 Coffee Rd BLDG
Suite 2
Modesto, CA 95355-3191

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

NPI Registry JSON

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801888284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1316 COFFEE RD",
            "address_2": "BLDG. A-2",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953553191",
            "telephone_number": "209-527-3557",
            "fax_number": "209-527-6739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1316 COFFEE RD",
            "address_2": "BLDG. A-2",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953553191",
            "telephone_number": "209-527-3557",
            "fax_number": "209-527-6739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORAKIS",
        "first_name": "PAUL",
        "middle_name": "ATHONY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "15466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

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.