Individual provider Active NPI

Anthony Gerald D'Agostino, D.C., B.A.

  • Chiropractor
  • Cape Coral, FL
National Provider Identifier
1912011305
Registry record updated Jul 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH 7971 Issued in FL
Practice address
1338 Del Prado Blvd S Ste 8
Cape Coral, FL 33990-3714
Phone
(239) 573-8918
Fax
(239) 573-8920
NPI assigned
Aug 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH 7971 FL Primary

Addresses

Primary practice location

1338 Del Prado Blvd S Ste 8
Cape Coral, FL 33990-3714

Mailing address

1338 Del Prado Blvd S Ste 8
Cape Coral, FL 33990-3714
Phone (239) 573-8918

Other identifiers 5

IdentifierTypeStateIssuer
381333900MedicaidFL
53909ZOtherFLINDIVIDUAL PTAN
CH 7971OtherFLFL LICENSE NUMBER
FB090AOtherFLGROUP PTAN
53909OtherFLFL BCBS NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110623000252 FL Practitioner - Chiropractic 8426236399 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1338 Del Prado Blvd S
Suite 8
Cape Coral, FL 33990-3714
Phone (239) 573-8918

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Arts

State licenses

LicenseStateTypeSpecialty
CH 7971FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Tony D'Agostino DC PA Chiropractor CurrentSince Feb 6, 2011 Accepting new patients

Locations

1338 Del Prado Blvd S
Ste 8
Cape Coral, FL 33990
Phone (239) 573-8918

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": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311033600000",
    "number": "1912011305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1338 DEL PRADO BLVD S STE 8",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339903714",
            "telephone_number": "239-573-8918",
            "fax_number": "239-573-8920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1338 DEL PRADO BLVD S STE 8",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339903714",
            "telephone_number": "239-573-8918",
            "fax_number": "239-573-8920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'AGOSTINO",
        "first_name": "ANTHONY",
        "middle_name": "GERALD",
        "name_prefix": "Dr.",
        "credential": "D.C., B.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2011-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH 7971",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "381333900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL PTAN",
            "identifier": "53909Z",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL LICENSE NUMBER",
            "identifier": "CH 7971",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "FB090A",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL BCBS NUMBER",
            "identifier": "53909",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2011; 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.