Individual provider Active NPI

Michael V Durante, DC

  • Chiropractor
  • Leesburg, FL
National Provider Identifier
1821067968
Registry record updated Feb 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH0004908 Issued in FL
Practice address
1235 W Dixie Ave
Leesburg, FL 34748-6315
Phone
(352) 787-2785
Fax
(352) 787-4484
NPI assigned
Mar 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH0004908 FL Primary

Addresses

Primary practice location

1235 W Dixie Ave
Leesburg, FL 34748-6315

Mailing address

1235 W Dixie Ave
Leesburg, FL 34748-6315
Phone (352) 787-2785

Other identifiers 3

IdentifierTypeStateIssuer
381397500MedicaidFL
350055849OtherFLRAILROAD MEDICARE
70930OtherFLBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100723000864 FL Practitioner - Chiropractic 5799815874 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1985
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1235 W Dixie Ave
Leesburg, FL 34748-6315
Phone (352) 787-2785

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH0004908FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Michael V Durante DC PA Chiropractor CurrentSince Feb 2, 2010 Accepting new patients

Locations

1235 W Dixie Ave
Leesburg, FL 34748
Phone (352) 787-2785

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": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265241600000",
    "number": "1821067968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1235 W DIXIE AVE",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347486315",
            "telephone_number": "352-787-2785",
            "fax_number": "352-787-4484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 W DIXIE AVE",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347486315",
            "telephone_number": "352-787-2785",
            "fax_number": "352-787-4484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURANTE",
        "first_name": "MICHAEL",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2010-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH0004908",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "381397500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "350055849",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "70930",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2010; 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.