Active NPI
Shaun Michael Bezak, D.C.
- Chiropractor
- Greenbelt, MD
National Provider Identifier
1871685677
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- S02141
- Practice address
- 7500 Hanover Pkwy Ste 102
Greenbelt, MD 20770-2011 - Phone
- (301) 220-0496
- Fax
- (301) 220-2303
- NPI assigned
- Sep 29, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | SO2141 | MD | |
| Chiropractor | 111N00000X | S02141 | MD | Primary |
Addresses
Primary practice location
7500 Hanover Pkwy Ste 102
Greenbelt, MD 20770-2011
Mailing address
7500 Hanover Pkwy Ste 102
Greenbelt, MD 20770-2011
Phone (301) 220-0496
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1039615 | Other | MD | ASHN/CIGNA |
| 61837201 | Other | MD | BLUE CROSS BLUE SHIELD MD |
| 7879466 | Other | MD | AETNA/PROVIDER NON HMO |
| G7520001 | Other | MD | BLUE CROSS BLUE SHIELD DC |
| 2319509 | Other | MD | UNITED HEALTHCARE |
| 2096855 | Other | MD | FIRST HEALTH/MAILHANDLERS |
| 2120465 | Other | MD | MAMSI/MDIPA/OPT./ALLIANCE |
| 652647 | Other | MD | ACN |
| 3137927 | Other | MD | AETNA PROVIDER HMO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Northwestern College of Chiropractic, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
7500 Hanover Pkwy
Suite 102
Greenbelt, MD 20770-2011
Phone (301) 220-0496
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S02141 | MD | MD | Chiropractor |
| SO2141 | MD | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bezak Chiropractic and Rehabilitation, P.a. | Chiropractor | Current | Accepting new patients |
Locations
7415 Greenbelt Rd
Greenbelt, MD 20770
Phone (301) 220-0496
7500 Hanover Pkwy
Ste 102
Greenbelt, MD 20770
Phone (301) 220-0496
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": "1159488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599609600000",
"number": "1871685677",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7500 HANOVER PKWY STE 102",
"city": "GREENBELT",
"state": "MD",
"postal_code": "207702011",
"telephone_number": "301-220-0496",
"fax_number": "301-220-2303"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7500 HANOVER PKWY STE 102",
"city": "GREENBELT",
"state": "MD",
"postal_code": "207702011",
"telephone_number": "301-220-0496",
"fax_number": "301-220-2303"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEZAK",
"first_name": "SHAUN",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-29",
"last_updated": "2020-09-09",
"certification_date": "2020-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "SO2141",
"primary": false
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MD",
"license": "S02141",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ASHN/CIGNA",
"identifier": "1039615",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD MD",
"identifier": "61837201",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA/PROVIDER NON HMO",
"identifier": "7879466",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD DC",
"identifier": "G7520001",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "2319509",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST HEALTH/MAILHANDLERS",
"identifier": "2096855",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMSI/MDIPA/OPT./ALLIANCE",
"identifier": "2120465",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ACN",
"identifier": "652647",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PROVIDER HMO",
"identifier": "3137927",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Greenbelt, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 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.