Individual provider Active NPI

Dexter Daniel Dimarco Jr., DC

  • Chiropractor
  • Lake Worth, FL
National Provider Identifier
1982694956
Registry record updated Apr 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH0005566 Issued in FL
Practice address
3938 Pinehurst Dr
Lake Worth, FL 33467-2944
Phone
(561) 641-4900
Fax
(561) 641-0136
NPI assigned
Oct 21, 2005
Last updated
Apr 1, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH0005566 FL Primary

Addresses

Primary practice location

3938 Pinehurst Dr
Lake Worth, FL 33467-2944

Mailing address

3938 Pinehurst Drive
Lake Worth, FL 33467
Phone (561) 641-4900

Other identifiers 1

IdentifierTypeStateIssuer
052285600MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110311000598 FL Practitioner - Chiropractic 8921001389 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Salvatore Larusso D C P a IIGroup PAC ID 5294738654, 2 clinicians

Practice addresses (Care Compare)

3938 Pinehurst Dr
Lake Worth, FL 33467-2944
Phone (561) 641-4900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH0005566FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Salvatore Larusso D C P a II Chiropractor CurrentSince Feb 1, 2002 Accepting new patients

Locations

3938 Pinehurst Dr
Lake Worth, FL 33467
Phone (561) 461-4900

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": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364774400000",
    "number": "1982694956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3938 PINEHURST DRIVE",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "33467",
            "telephone_number": "561-641-4900",
            "fax_number": "561-641-0136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3938 PINEHURST DR",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334672944",
            "telephone_number": "561-641-4900",
            "fax_number": "561-641-0136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMARCO",
        "first_name": "DEXTER",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-21",
        "last_updated": "2013-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH0005566",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "052285600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Worth, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2013; 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.