Active NPI
John Robert Delisi, D.C.
- Chiropractor
- Pomona, NY
National Provider Identifier
1902983885
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- X011091-1
- Practice address
- 11 Medical Park Dr
Suite 104
Pomona, NY 10970-3559 - Phone
- (845) 354-5180
- Fax
- (845) 354-4104
- NPI assigned
- Oct 31, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 38MC00173800 | NJ | |
| Chiropractor | 111N00000X | X011091-1 | NY | Primary |
| Chiropractor | 111N00000X | 12151 | CA |
Addresses
Primary practice location
11 Medical Park Dr
Suite 104
Pomona, NY 10970-3559
Mailing address
25 Nansen CT
Spring Valley, NY 10977-3143
Phone (845) 352-0362
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
| License | State | Type | Specialty |
|---|---|---|---|
| 38MC00173800 | NJ | MD | Chiropractor |
| X011091-1 | NY | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Andrew M Rodgers | Chiropractor | Past | Accepting new patients |
| Pomona Pain Management | Chiropractor | Past | Accepting new patients |
| Axiomwellness LLC | Past | Accepting new patients | |
| Axiomwellness LLC | Chiropractor | Past | Accepting new patients |
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Physical Medicine & Rehabilitation Physician
- Pomona, NY
- NPI 1750332128
Chiropractor
-
- Customized Equipment (DME)
- Fort Lee, NJ
- NPI 1538308762
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1286236800000",
"number": "1902983885",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 NANSEN CT",
"city": "SPRING VALLEY",
"state": "NY",
"postal_code": "109773143",
"telephone_number": "845-352-0362"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11 MEDICAL PARK DR",
"address_2": "SUITE 104",
"city": "POMONA",
"state": "NY",
"postal_code": "109703559",
"telephone_number": "845-354-5180",
"fax_number": "845-354-4104"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELISI",
"first_name": "JOHN",
"middle_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-31",
"last_updated": "2010-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NJ",
"license": "38MC00173800",
"primary": false
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NY",
"license": "X011091-1",
"primary": true
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "12151",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pomona, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.