Individual provider Active NPI

Peter M Silecchio, D.C.

  • Chiropractor
  • Simi Valley, CA
National Provider Identifier
1992832299
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC24610 Issued in CA
Practice address
4519 Alamo St
Simi Valley, CA 93063-1734
Phone
(805) 584-1634
Fax
(805) 526-8200
NPI assigned
Feb 27, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC24610 CA Primary

Addresses

Primary practice location

4519 Alamo St
Simi Valley, CA 93063-1734

Mailing address

4519 Alamo St
Simi Valley, CA 93063-1734
Phone (805) 584-1634

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060112000477 CA Practitioner - Chiropractic 4981627239 Practice locations: Simi Valley, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Los Angeles, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2256 Tapo St
Simi Valley, CA 93063-3022
Phone (805) 584-1634

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC24610CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Hybrid Healthcare Corporation Chiropractor PastSince Oct 8, 2014 Accepting new patients

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": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992832299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4519 ALAMO ST",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930631734",
            "telephone_number": "805-584-1634",
            "fax_number": "805-526-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4519 ALAMO ST",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930631734",
            "telephone_number": "805-584-1634",
            "fax_number": "805-526-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SILECCHIO",
        "first_name": "PETER",
        "middle_name": "M",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC24610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Simi Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.