Individual provider Active NPI

Nicholas J Dragonette

  • Chiropractor
  • Orchard Park, NY
National Provider Identifier
1962583021
Registry record updated Oct 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X3804 Issued in NY
Practice address
S. 3405 Orchard Park Rd
Orchard Park, NY 14127-1618
Phone
(716) 675-0515
Fax
(716) 674-0394
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X3804 NY Primary

Addresses

Primary practice location

S. 3405 Orchard Park Rd
Orchard Park, NY 14127-1618

Mailing address

S. 3405 Orchard Park Rd
Orchard Park, NY 14127-1618
Phone (716) 675-0515

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
003804NYMDClinical Psychologist
X3804NYMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665705600000",
    "number": "1962583021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "S. 3405 ORCHARD PARK RD",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271618",
            "telephone_number": "716-675-0515",
            "fax_number": "716-674-0394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "S. 3405 ORCHARD PARK RD",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271618",
            "telephone_number": "716-675-0515",
            "fax_number": "716-674-0394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAGONETTE",
        "first_name": "NICHOLAS",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2022-10-14",
        "certification_date": "2022-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X3804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orchard Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2022; 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.