Individual provider Active NPI

Brett Patrick Decesare, D.C.

  • Chiropractor
  • Caruthers, CA
National Provider Identifier
1811074594
Registry record updated Sep 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC17579 Issued in CA
Practice address
13416 S. Oak
Caruthers, CA 93609
Phone
(559) 864-9457
Fax
(559) 864-0109
NPI assigned
Nov 1, 2006
Last updated
Sep 14, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC17579 CA Primary

Addresses

Primary practice location

13416 S. Oak
Caruthers, CA 93609

Mailing address

PO Box 787
Caruthers, CA 93609-0787
Phone (559) 864-9457

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120904000033 CA Practitioner - Chiropractic 7416104021 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

13416 S Oak
Caruthers, CA 93609
Phone (559) 864-9457

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC17579CAMDChiropractor
17579CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Decesare Chiropractic Inc. Chiropractor CurrentSince Feb 21, 2012 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347580800000",
    "number": "1811074594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 787",
            "city": "CARUTHERS",
            "state": "CA",
            "postal_code": "936090787",
            "telephone_number": "559-864-9457",
            "fax_number": "559-864-0109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13416 S. OAK",
            "city": "CARUTHERS",
            "state": "CA",
            "postal_code": "93609",
            "telephone_number": "559-864-9457",
            "fax_number": "559-864-0109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECESARE",
        "first_name": "BRETT",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2012-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC17579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caruthers, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2012; 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.