Individual provider Active NPI

Kashain Srisuro, D.C.

  • Chiropractor
  • Plymouth Meeting, PA
National Provider Identifier
1871785949
Registry record updated Feb 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC009799 Issued in PA
Practice address
1033 Germantown Pike
Plymouth Meeting, PA 19462-2449
Phone
(484) 684-7002
Fax
(484) 684-7053
NPI assigned
Aug 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC009799 PA Primary

Addresses

Primary practice location

1033 Germantown Pike
Plymouth Meeting, PA 19462-2449

Mailing address

1033 Germantown Pike
Plymouth Meeting, PA 19462-2449
Phone (484) 684-7002

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071113000475 PA Practitioner - Chiropractic 0446348106 Reassigns benefits to 1 organization

Care Compare profile

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

Practice addresses (Care Compare)

1033 Germantown Pike
Plymouth Meeting, PA 19462-2449
Phone (484) 684-7002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC009799PAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Comfort Care Chiropractic PC Chiropractor CurrentSince Dec 1, 2009 Accepting new patients
Phido Audiology and Hearing AIDS, LLC Past Accepting new patients
Morgenstern Chiropractic PC Chiropractor Past Accepting new patients

Locations

1033 Germantown Pike
Plymouth Meeting, PA 19462
Phone (484) 684-7002

Organizations & group practices 3

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": "1186963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266192000000",
    "number": "1871785949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1033 GERMANTOWN PIKE",
            "city": "PLYMOUTH MEETING",
            "state": "PA",
            "postal_code": "194622449",
            "telephone_number": "484-684-7002",
            "fax_number": "484-684-7053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1033 GERMANTOWN PIKE",
            "city": "PLYMOUTH MEETING",
            "state": "PA",
            "postal_code": "194622449",
            "telephone_number": "484-684-7002",
            "fax_number": "484-684-7053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SRISURO",
        "first_name": "KASHAIN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-13",
        "last_updated": "2010-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC009799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth Meeting, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2010; 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.