Kevin Thomas Percuoco, DC

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

081984 Issued in IA

Practice address

17330 Bear Valley Rd Ste 105
Victorville, CA 92395-7741

Phone

(760) 245-8182

Fax

(760) 245-2123

NPI assigned

Apr 19, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Palmer College FoundationGroup PAC ID 1557266863, 44 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Palmer College Foundation

  • Chiropractor
  • Davenport, IA
  • NPI 1174535181
  Medicare reassignment Care Compare group NPD
• Percuoco Chiropractic and Rehabilitation, PLLC

  • Sports Physician Chiropractor
  • Des Moines, IA
  • NPI 1427685569
  NPD Authorized official

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

{
    "created_epoch": "1524096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585180800000",
    "number": "1821585357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 INGERSOLL AVE STE E",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503123917",
            "telephone_number": "515-620-3550",
            "fax_number": "515-259-6383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17330 BEAR VALLEY RD STE 105",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923957741",
            "telephone_number": "760-245-8182",
            "fax_number": "760-245-2123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERCUOCO",
        "first_name": "KEVIN",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-19",
        "last_updated": "2020-03-26",
        "certification_date": "2020-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "33702",
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "IA",
            "license": "081984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacey Pelayo
• Selena Pena
• Debrah Bernice Pence, RFM
• People'S Care Autism Services, Inc.
• Peoples Care Autism Services
• Chikyra Anne Percy, LCSW
• Iliana Karina Perea
• Ingrid Perea
• Ferdinand Perez - Rodriguez, MD
• Alicia Rodriguez Perez, LCSW

• Sports Physician Chiropractor in Victorville, CA
• Providers in Victorville, CA by specialty
• Sports Physician Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2020; 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.