Individual provider Active NPI

Michael Tiso, D.C.

  • Chiropractor
  • Hayes, VA
National Provider Identifier
1811281561
Registry record updated Apr 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104556884 Issued in VA
Practice address
3073 George Washington Memorial Hwy
Hayes, VA 23072-3300
Phone
(757) 202-2960
NPI assigned
May 30, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104556884 VA Primary

Addresses

Primary practice location

3073 George Washington Memorial Hwy
Hayes, VA 23072-3300

Mailing address

3073 George Washington Memorial Hwy
Hayes, VA 23072-3300
Phone (804) 684-5196

Other practice location 1

201 Bulifants Blvd Ste B
Williamsburg, VA 23188-5731
Phone (757) 603-6655

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150616000360 VA Practitioner - Chiropractic 9234440405 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Sherman College of Straight Chiropractic, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1811 George Washington Memorial Hwy
Gloucester Point, VA 23062-2220
Phone (804) 684-5196

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0104556884VAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Courthouse Chiropractic, LLC Chiropractor CurrentSince Jan 9, 2019 Accepting new patients
Comber Physical Therapy, LLC CurrentSince Aug 23, 2021 Accepting new patients

Locations

1811 George Washington Memorial Hwy
Gloucester Pt, VA 23062
Phone (757) 202-2960

3073 George Washington Memorial Hwy
Hayes, VA 23072
Phone (757) 202-2960

5388 Discovery Park Blvd
Ste 200
Williamsburg, VA 23188

201 Bulifants Blvd
Ste B
Williamsburg, VA 23188
Phone (757) 229-9740

Organizations & group practices 2

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": "1306713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681948800000",
    "number": "1811281561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3073 GEORGE WASHINGTON MEMORIAL HWY",
            "city": "HAYES",
            "state": "VA",
            "postal_code": "230723300",
            "telephone_number": "804-684-5196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3073 GEORGE WASHINGTON MEMORIAL HWY",
            "city": "HAYES",
            "state": "VA",
            "postal_code": "230723300",
            "telephone_number": "757-202-2960"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 Bulifants Blvd Ste B",
            "address_purpose": "LOCATION",
            "city": "Williamsburg",
            "state": "VA",
            "postal_code": "231885731",
            "country_code": "US",
            "telephone_number": "757-603-6655",
            "fax_number": "757-229-9741",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TISO",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-30",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104556884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hayes, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2023; 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.