Individual provider Active NPI

Michael Matthew Quartararo, D.C

  • Chiropractor
  • Ballston Spa, NY
National Provider Identifier
1891701991
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X007487 Issued in NY
Practice address
402 Rowland St
Ballston Spa, NY 12020-2684
Phone
(518) 363-0202
Fax
(518) 363-0711
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X007487 NY Primary

Addresses

Primary practice location

402 Rowland St
Ballston Spa, NY 12020-2684

Mailing address

402 Rowland St
Ballston Spa, NY 12020-2684
Phone (518) 363-0202

Other identifiers 1

IdentifierTypeStateIssuer
10029107OtherNYCDPHP

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111110000245 NY Practitioner - Chiropractic 2466400890 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 1993
Medicare assignment
May accept Medicare assignment
Group practices
Adirondack Advanced Chiropractic, PCGroup PAC ID 1658329073, 2 clinicians

Practice addresses (Care Compare)

402 Rowland St
Ballston Spa, NY 12020-2684
Phone (518) 363-0202

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X007487NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Adirondack Advanced Chiropractic, PC Chiropractor CurrentSince Aug 17, 2001 Accepting new patients
Adio Chiropractic, PLLC Chiropractor PastSince Dec 1, 2005 Accepting new patients

Locations

402 Rowland St
Ballston Spa, NY 12020
Phone (518) 363-0202

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891701991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 ROWLAND ST",
            "city": "BALLSTON SPA",
            "state": "NY",
            "postal_code": "120202684",
            "telephone_number": "518-363-0202",
            "fax_number": "518-363-0711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 ROWLAND ST",
            "city": "BALLSTON SPA",
            "state": "NY",
            "postal_code": "120202684",
            "telephone_number": "518-363-0202",
            "fax_number": "518-363-0711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUARTARARO",
        "first_name": "MICHAEL",
        "middle_name": "MATTHEW",
        "name_prefix": "Mr.",
        "credential": "D.C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X007487",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPHP",
            "identifier": "10029107",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ballston Spa, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.