Individual provider Active NPI

James John Demarino, DC

  • Chiropractor
  • Phila, PA
National Provider Identifier
1992896963
Registry record updated Mar 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC006292L Issued in PA
Practice address
2505 S Broad St
Phila, PA 19148
Phone
(215) 551-3340
Fax
(215) 551-3320
NPI assigned
Sep 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC006292L PA Primary

Addresses

Primary practice location

2505 S Broad St
Phila, PA 19148

Mailing address

2505 S Broad St
Phila, PA 19148
Phone (215) 551-3340

Other identifiers 2

IdentifierTypeStateIssuer
01568036MedicaidPA
0777239000OtherPABCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071204000059 PA Practitioner - Chiropractic 6002905700 Practice locations: Philadelphia, PA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC006292LPAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Demarino Chiropractic Center Chiropractor PastSince Jan 1, 1990 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.

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1995
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2505 S Broad St
Phila, PA 19148-4309

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206489600000",
    "number": "1992896963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2505 S BROAD ST",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "19148",
            "telephone_number": "215-551-3340",
            "fax_number": "215-551-3320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2505 S BROAD ST",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "19148",
            "telephone_number": "215-551-3340",
            "fax_number": "215-551-3320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMARINO",
        "first_name": "JAMES",
        "middle_name": "JOHN",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2008-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC006292L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01568036",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0777239000",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phila, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2008; 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.