Individual provider Active NPI

George Yacoub Aoude, DC

  • Chiropractor
  • Quincy, MA
National Provider Identifier
1992227482
Registry record updated Nov 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3586 Issued in MA
Practice address
111 Willard St Ste 2a
Quincy, MA 02169-1274
Phone
(617) 471-4491
NPI assigned
Jul 17, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3586 MA Primary

Addresses

Primary practice location

111 Willard St Ste 2a
Quincy, MA 02169-1274

Mailing address

1860 Centre St
West Roxbury, MA 02132-1902

Other identifiers 1

IdentifierTypeStateIssuer
3586OtherMACHIROPRACTIC LICENSE NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170814001106 MA Practitioner - Chiropractic 7416228200 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1860 Centre St
Boston, MA 02132-1902
Phone (617) 775-3034

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3586MAMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
West Roxbury Spine and Sport LLC Chiropractor CurrentSince Aug 12, 2021 Accepting new patients

Locations

1860 Centre St
West Roxbury, MA 02132
Phone (617) 588-4272

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": "1500249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636934400000",
    "number": "1992227482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 CENTRE ST",
            "city": "WEST ROXBURY",
            "state": "MA",
            "postal_code": "021321902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 WILLARD ST STE 2A",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021691274",
            "telephone_number": "617-471-4491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AOUDE",
        "first_name": "GEORGE",
        "middle_name": "YACOUB",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-17",
        "last_updated": "2021-11-15",
        "certification_date": "2021-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "3586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIROPRACTIC LICENSE NUMBER",
            "identifier": "3586",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2021; 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.