Individual provider Active NPI

Ryan Seitz Kish, D.C.

  • Chiropractor
  • Palm Beach Gardens, FL
National Provider Identifier
1871672394
Registry record updated Oct 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH13481 Issued in FL
Practice address
11211 Prosperity Farms Rd Ste 204
Palm Beach Gardens, FL 33410-3467
Phone
(203) 470-2770
NPI assigned
Nov 3, 2006
Last updated
Oct 27, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH13481 FL Primary
Chiropractor 111N00000X 001697 CT

Addresses

Primary practice location

11211 Prosperity Farms Rd Ste 204
Palm Beach Gardens, FL 33410-3467

Mailing address

8110 Santalo Cove CT
Boynton Beach, FL 33473-5026
Phone (203) 470-2770

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221228000417 FL Practitioner - Chiropractic 6608246129 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11211 Prosperity Farms Rd
Suite 204
Palm Beach Gardens, FL 33410-3467
Phone (561) 622-9197

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001697CTMDMarriage & Family Therapist
CH13481FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Palm Beach Gardens DC & Ac, PLLC Chiropractor CurrentSince Nov 7, 2022 Accepting new patients

Locations

11211 Prosperity Farms Rd
Ste 204
Palm Beach Gardens, FL 33410
Phone (203) 470-2770

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": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666828800000",
    "number": "1871672394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8110 SANTALO COVE CT",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334735026",
            "telephone_number": "203-470-2770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11211 PROSPERITY FARMS RD STE 204",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334103467",
            "telephone_number": "203-470-2770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISH",
        "first_name": "RYAN",
        "middle_name": "SEITZ",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2022-10-27",
        "certification_date": "2022-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH13481",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CT",
            "license": "001697",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Beach Gardens, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2022; 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.