Individual provider Active NPI

Roger Saak Huang, D.C.

  • Chiropractor
  • Ashtabula, OH
National Provider Identifier
1821173873
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2933 Issued in OH
Practice address
2709 Lake Ave
Ashtabula, OH 44004-4959
Phone
(440) 998-2200
Fax
(440) 997-5695
NPI assigned
Oct 26, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 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 2933 OH Primary

Addresses

Primary practice location

2709 Lake Ave
Ashtabula, OH 44004-4959

Mailing address

2709 Lake Ave
Ashtabula, OH 44004-4959
Phone (440) 998-2200

Other identifiers 1

IdentifierTypeStateIssuer
2274426MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040624000040 OH Practitioner - Chiropractic 9436134541 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Kansas City, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2709 Lake Ave
Ashtabula, OH 44004-4959
Phone (440) 998-2200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2933OHMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ashtabula Chiropractic Clinic, Inc Chiropractor CurrentSince Oct 1, 1999 Accepting new patients

Locations

2709 Lake Ave
Ashtabula, OH 44004
Phone (440) 998-2200

2794 Som Center Rd
Willoughby Hills, OH 44094

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": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1821173873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2709 LAKE AVE",
            "city": "ASHTABULA",
            "state": "OH",
            "postal_code": "440044959",
            "telephone_number": "440-998-2200",
            "fax_number": "440-997-5695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2709 LAKE AVE",
            "city": "ASHTABULA",
            "state": "OH",
            "postal_code": "440044959",
            "telephone_number": "440-998-2200",
            "fax_number": "440-997-5695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUANG",
        "first_name": "ROGER",
        "middle_name": "SAAK",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "2933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2274426",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashtabula, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.