Individual provider Active NPI

Desiree Garavello, D.C.

  • Chiropractor
  • Sacramento, CA
National Provider Identifier
1891842910
Registry record updated Oct 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
26857 Issued in CA
Practice address
903 30TH St
Sacramento, CA 95816-4407
Phone
(916) 442-7474
Fax
(916) 442-7477
NPI assigned
Jan 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 26857 CA Primary

Addresses

Primary practice location

903 30TH St
Sacramento, CA 95816-4407

Mailing address

903 30TH St
Sacramento, CA 95816-4407
Phone (916) 442-7474

Other names 1

  • Dr. Desiree Crusade Professional name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031126000759 CA Practitioner - Chiropractic 1658276092 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1999
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1120 Corporate Way
Sacramento, CA 95831-3875
Phone (916) 442-7474

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26857CAMDOccupational Therapist

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": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350432000000",
    "number": "1891842910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 30TH ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958164407",
            "telephone_number": "916-442-7474",
            "fax_number": "916-442-7477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 30TH ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958164407",
            "telephone_number": "916-442-7474",
            "fax_number": "916-442-7477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARAVELLO",
        "first_name": "DESIREE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2012-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "26857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DESIREE",
            "last_name": "CRUSADE",
            "prefix": "DR.",
            "credential": "D.C.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2012; 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.