Individual provider Active NPI

Charles L Mitzelfeld, DC

  • Chiropractor
  • West Palm Beach, FL
National Provider Identifier
1932105335
Registry record updated Apr 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH5144 Issued in FL
Practice address
1395 N Military TRL
West Palm Beach, FL 33409-6016
Phone
(561) 684-0333
Fax
(561) 684-8587
NPI assigned
Jun 22, 2005
Last updated
Apr 3, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH5144 FL Primary

Addresses

Primary practice location

1395 N Military TRL
West Palm Beach, FL 33409-6016

Mailing address

1395 N Military TRL
West Palm Beach, FL 33409-6016
Phone (561) 684-0333

Other identifiers 1

IdentifierTypeStateIssuer
381521800MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050119001087 FL Practitioner - Chiropractic 8820047574 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

14100 US Hwy 1
Juno Beach, FL 33408-1404
Phone (561) 626-6711

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH5144FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Foundation Chiropractic Clinic Inc Chiropractor CurrentSince Feb 5, 1996 Accepting new patients
Lantana Chiromed Centers Chiropractor Past Accepting new patients

Locations

14100 US Highway 1
Juno Beach, FL 33408
Phone (561) 262-9072

1195 N Military Trl
West Palm Beach, FL 33409
Phone (561) 683-4100

1395 N Military Trl
West Palm Beach, FL 33409
Phone (561) 683-0023

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207180800000",
    "number": "1932105335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 N MILITARY TRL",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334096016",
            "telephone_number": "561-684-0333",
            "fax_number": "561-684-8587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1395 N MILITARY TRL",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334096016",
            "telephone_number": "561-684-0333",
            "fax_number": "561-684-8587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITZELFELD",
        "first_name": "CHARLES",
        "middle_name": "L",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2008-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH5144",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "381521800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2008; 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.