Individual provider Active NPI

Wilfredo Morales III, D.C.

  • Chiropractor
  • Ronkonkoma, NY
National Provider Identifier
1952730525
Registry record updated Jun 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X012434 Issued in NY
Practice address
352 Rosevale Ave
Ronkonkoma, NY 11779-3036
Phone
(631) 774-5241
Fax
(631) 737-3356
NPI assigned
Nov 5, 2013
Last updated
Jun 18, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X012434 NY Primary

Addresses

Primary practice location

352 Rosevale Ave
Ronkonkoma, NY 11779-3036

Mailing address

352 Rosevale Ave
Ronkonkoma, NY 11779-3036
Phone (631) 774-5241

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140929000760 NY Practitioner - Chiropractic 2668692526 Practice locations: Ronkonkoma, NY

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

352 Rosevale Ave
Ronkonkoma, NY 11779-3036
Phone (631) 774-5241

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X012434NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Talay Family Chiropractic PC Past Accepting new patients

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, 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": "1383609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560816000000",
    "number": "1952730525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "352 ROSEVALE AVE",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117793036",
            "telephone_number": "631-774-5241",
            "fax_number": "631-619-1895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "352 ROSEVALE AVE",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117793036",
            "telephone_number": "631-774-5241",
            "fax_number": "631-737-3356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORALES",
        "first_name": "WILFREDO",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-11-05",
        "last_updated": "2019-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X012434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ronkonkoma, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2019; 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.