Active NPI
Philip J Scuderi, DC
- Chiropractor
- Palm Beach Gardens, FL
National Provider Identifier
1992702906
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CH7741
- Practice address
- 4794 Northlake Blvd Ste B
Palm Beach Gardens, FL 33418-5910 - Phone
- (561) 775-4900
- Fax
- (561) 775-0003
- NPI assigned
- Jul 5, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CH7741 | FL | Primary |
Addresses
Primary practice location
4794 Northlake Blvd Ste B
Palm Beach Gardens, FL 33418-5910
Mailing address
4794 Northlake Blvd Ste B
Palm Beach Gardens, FL 33418-5910
Phone (561) 775-4900
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110207000625 | FL | Practitioner - Chiropractic | 1759465891 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721088000000",
"number": "1992702906",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4794 NORTHLAKE BLVD STE B",
"city": "PALM BEACH GARDENS",
"state": "FL",
"postal_code": "334185910",
"telephone_number": "561-775-4900",
"fax_number": "561-775-0003"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4794 NORTHLAKE BLVD STE B",
"city": "PALM BEACH GARDENS",
"state": "FL",
"postal_code": "334185910",
"telephone_number": "561-775-4900",
"fax_number": "561-775-0003"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCUDERI",
"first_name": "PHILIP",
"middle_name": "J",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-05",
"last_updated": "2024-07-16",
"certification_date": "2024-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "FL",
"license": "CH7741",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palm Beach Gardens, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.