John Matthew Bystrom, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC30236 Issued in CA

Practice address

1933 Coffee Rd
Modesto, CA 95355-2704

Phone

(209) 838-3434

Fax

(209) 838-7753

NPI assigned

Dec 22, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College - West, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Escalon Physical Medicine IncGroup PAC ID 4880918192, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Escalon Physical Medicine, Inc

  • Family Medicine Physician
  • Modesto, CA
  • NPI 1821417866
  Medicare reassignment Care Compare group NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673395200000",
    "number": "1891850525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1933 COFFEE RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953552704",
            "telephone_number": "209-380-7975",
            "fax_number": "209-838-7753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1933 COFFEE RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953552704",
            "telephone_number": "209-838-3434",
            "fax_number": "209-838-7753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYSTROM",
        "first_name": "JOHN",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-22",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC30236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Chirotouch",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1933 Coffee Rd",
            "city": "Modesto",
            "state": "CA",
            "country_code": "US",
            "postal_code": "953552704",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Freda By
• David B Bybee, M.D.
• Teresa Byrd Mendoza
• Alexa Byrd
• Michelle Diane Byrd, BHS II, SUDCC
• Michael Eric Bystrom, DC
• Jamie Byun, MD
• C. N. Zertuche, Inc., a Professional Dental Corporation
• Rosario Caballero-Herrera
• Julissa Caballero, LCSW

• Chiropractor in Modesto, CA
• Providers in Modesto, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2023; 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.