Individual provider Active NPI

Joseph J Pacelli, D.C.

  • Chiropractor
  • Tustin, CA
National Provider Identifier
1891701413
Registry record updated Jun 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC30257 Issued in CA
Practice address
17251 17TH St Ste a
Tustin, CA 92780-1963
Phone
(714) 832-2273
Fax
(714) 832-2272
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC30257 CA Primary

Addresses

Primary practice location

17251 17TH St Ste a
Tustin, CA 92780-1963

Mailing address

17251 17TH St Ste a
Tustin, CA 92780-1963
Phone (714) 832-2273

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070320000707 CA Practitioner - Chiropractic 8123121621 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Los Angeles College of Chiropractic, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ideal Therapy IncGroup PAC ID 9638422454, 2 clinicians

Practice addresses (Care Compare)

2617 E Chapman Ave
Suite 105
Orange, CA 92869-3255
Phone (714) 832-2273

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC30257CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Ideal Therapy, Inc Chiropractor CurrentSince Dec 1, 2018 Accepting new patients
Ideal Spine & Rehab Chiropractor PastSince Apr 1, 2013 Accepting new patients

Locations

420 W Rowland St
Covina, CA 91723
Phone (626) 331-6411

4281 Katella Ave
Los Alamitos, CA 90720
Phone (626) 270-9400

4281 Katella Ave
Ste 222
Los Alamitos, CA 90720

2617 E Chapman Ave
Ste 105
Orange, CA 92869
Phone (714) 639-1915

2617 E Chapman Ave
Ste 110
Orange, CA 92869
Phone (714) 633-0011

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403136000000",
    "number": "1891701413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17251 17TH ST STE A",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927801963",
            "telephone_number": "714-832-2273",
            "fax_number": "714-832-2272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17251 17TH ST STE A",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927801963",
            "telephone_number": "714-832-2273",
            "fax_number": "714-832-2272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACELLI",
        "first_name": "JOSEPH",
        "middle_name": "J",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2014-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC30257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2014; 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.