Individual provider Active NPI

Sean Mathew Epstein, D.C.

  • Chiropractor
  • Philadelphia, PA
National Provider Identifier
1992744320
Registry record updated Dec 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC008795 Issued in PA
Practice address
1619 Grant Ave Ste 1
Philadelphia, PA 19115-3162
Phone
(267) 969-0082
Fax
(267) 686-8606
NPI assigned
Jun 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH7656 FL
Chiropractor 111N00000X DC008795 PA Primary

Addresses

Primary practice location

1619 Grant Ave Ste 1
Philadelphia, PA 19115-3162

Mailing address

1619 Grant Ave Ste 1
Philadelphia, PA 19115-3162
Phone (267) 969-0082

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060928000516 PA Practitioner - Chiropractic 3173528916 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10804 Bustleton Ave
Philadelphia, PA 19116-3302
Phone (215) 696-1900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH7656FLMDChiropractor
DC008795PAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Chiropractic Bodyshop, P.C. Chiropractor CurrentSince Jul 10, 2006 Accepting new patients
Avon Discount Pharmacy LLC PastSince Sep 15, 2019 Accepting new patients

Locations

10804 Bustleton Ave
Philadelphia, PA 19116
Phone (215) 696-1900

1619 Grant Ave
Ste 1
Philadelphia, PA 19115
Phone (215) 613-5929

10808 Bustleton Ave
Philadelphia, PA 19116
Phone (215) 464-8600

10752 Bustleton Ave
#E9
Philadelphia, PA 19116

Organizations & group practices 2

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": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1992744320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1619 GRANT AVE STE 1",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191153162",
            "telephone_number": "267-969-0082",
            "fax_number": "267-686-8606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1619 GRANT AVE STE 1",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191153162",
            "telephone_number": "267-969-0082",
            "fax_number": "267-686-8606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EPSTEIN",
        "first_name": "SEAN",
        "middle_name": "MATHEW",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-04",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH7656",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC008795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2023; 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.