Individual provider Active NPI

Charbel Medlej, D.C.

  • Chiropractor
  • Canandaigua, NY
National Provider Identifier
1821689316
Registry record updated Jan 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104-557673 Issued in VA
Practice address
400 Fort Hill Ave
Canandaigua, NY 14424-1159
Phone
(585) 394-2000
NPI assigned
Jan 28, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104-557673 VA Primary

Addresses

Primary practice location

400 Fort Hill Ave
Canandaigua, NY 14424-1159

Mailing address

400 Fort Hill Ave
Canandaigua, NY 14424-1159

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230914002501 VA Practitioner - ChiropracticPractitioner - Other (Physician) 4587028204 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Can-Am Chiropractic and Wellness Chiropractor CurrentSince Apr 18, 2023 Accepting new patients

Locations

150 Olde Greenwich Dr
Ste 100
Fredericksburg, VA 22408
Phone (540) 395-5985

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": "1611792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1821689316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 FORT HILL AVE",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144241159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 FORT HILL AVE",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144241159",
            "telephone_number": "585-394-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDLEJ",
        "first_name": "CHARBEL",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-28",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104-557673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canandaigua, NY

Sources for this page

Verify at the official NPI Registry.