NPIMap

Organization Active NPI

Tetuan Innovative Chiropractic Care P.S.

  • Chiropractor
  • Bellevue, WA
National Provider Identifier
1861738064
Registry record updated Dec 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
TETUAN INNOVATIVE CHIROPRACTIC CARE P.S.
Practice address
1215 120TH Ave NE
Suite 100
Bellevue, WA 98005-2135
Phone
(425) 455-3300
Fax
(425) 455-3304
NPI assigned
Dec 17, 2012
Last updated
Dec 17, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2012

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

Authorized official

Name
Dr. Adam Jason Tetuan, D.C.NPI 1972610665
Title
Owner
Phone
(425) 455-3300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU Primary

Addresses

Primary practice location

1215 120TH Ave NE
Suite 100
Bellevue, WA 98005-2135

Mailing address

1215 120TH Ave NE
Suite 100
Bellevue, WA 98005-2135
Phone (425) 455-3300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130321000204 WA Part B Supplier - Clinic/Group Practice 7810132974 Receives reassigned benefits from 1 practitioner
Practice locations: Bellevue, WA

National Provider Directory

National Provider Directory

Locations

1300 114th Ave SE
Ste 130
Bellevue, WA 98004
Phone (425) 281-7624

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1355702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355702400000",
    "number": "1861738064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 120TH AVE NE",
            "address_2": "SUITE 100",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980052135",
            "telephone_number": "425-455-3300",
            "fax_number": "425-455-3304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 120TH AVE NE",
            "address_2": "SUITE 100",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980052135",
            "telephone_number": "425-455-3300",
            "fax_number": "425-455-3304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TETUAN INNOVATIVE CHIROPRACTIC CARE P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-17",
        "last_updated": "2012-12-17",
        "status": "A",
        "authorized_official_last_name": "TETUAN",
        "authorized_official_first_name": "ADAM",
        "authorized_official_middle_name": "JASON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-455-3300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.