NPIMap

Individual provider Active NPI

Jeremiah James Diruzzo, D.C.

  • Chiropractor
  • Mattapan, MA
National Provider Identifier
1902095391
Registry record updated Sep 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3136 Issued in MA
Practice address
1520 Blue Hill Ave
Mattapan, MA 02126-1747
Phone
(617) 298-6325
Fax
(617) 298-5410
NPI assigned
Oct 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 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 3136 MA Primary

Addresses

Primary practice location

1520 Blue Hill Ave
Mattapan, MA 02126-1747

Mailing address

1520 Blue Hill Ave
Mattapan, MA 02126-1747
Phone (617) 298-6325

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3163MAMDCardiopulmonary Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kantorosinski Chiropractic Inc Chiropractor PastSince Mar 30, 2015 Accepting new patients
Be Pain Free PT Inc PastSince Apr 1, 2014 Accepting new patients

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": "1193011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347580800000",
    "number": "1902095391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 BLUE HILL AVE",
            "city": "MATTAPAN",
            "state": "MA",
            "postal_code": "021261747",
            "telephone_number": "617-298-6325",
            "fax_number": "617-298-5410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 BLUE HILL AVE",
            "city": "MATTAPAN",
            "state": "MA",
            "postal_code": "021261747",
            "telephone_number": "617-298-6325",
            "fax_number": "617-298-5410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIRUZZO",
        "first_name": "JEREMIAH",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-22",
        "last_updated": "2012-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "3136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mattapan, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.