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CONNEAUT LAKE CHIROPRACTIC, PC
NPI 1396918215
Chiropractor in Conneaut Lake, PA

Active since April 11, 2008
13245 CONNEAUT LAKE RD, CONNEAUT LAKE, PA 16316(814) 382-8840(814) 382-8840 Get Directions Write a Review

NPPES record last updated: April 11, 2008. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Conneaut Lake Chiropractic, Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CONNEAUT LAKE CHIROPRACTIC, PC (NPI 1396918215) is a healthcare organization registered as a chiropractor in Conneaut Lake, Pennsylvania and active in the NPI registry since April 2008. The organization lists Brett Alan Keyser, President, as its authorized official.

NPPES Registry Identity

NPI1396918215
Entity TypeOrganization
Primary Taxonomy111N00000X
Legal Business NameCONNEAUT LAKE CHIROPRACTIC, PC
Location Address13245 CONNEAUT LAKE RDConneaut Lake, PA 16316-6809
Mailing Address13245 Conneaut Lake RdConneaut Lake, PA 16316-6809 · (814) 382-8840 · Fax (814) 382-8840
Phone(814) 382-8840
Fax(814) 382-8840
Organization SubpartNo
Authorized OfficialBrett Alan KeyserPresident · (814) 382-8840
Enumeration DateApril 11, 2008
✔ NPI 1396918215 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers
Taxonomy Code111N00000X
License✔ Licensed in PA · DC007703L
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
13245 CONNEAUT LAKE RD, Conneaut Lake, PA 16316
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Other Identifiers 4

Medicare UPINU81485PA
Medicaid0017865180003PA
Medicare PIN041034PA
Other340625PA · Highmark Bcbs

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Conneaut Lake Chiropractic, Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by January 31, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StatePennsylvaniaEnrollment IDO20080828000376Non-DME Part B · Clinic/Group PracticeDue dateJanuary 31, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Conneaut Lake Chiropractic, PC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Brett Keyser, D.C.
Chiropractic
NPI 1083795801
13245 CONNEAUT LAKE RD
Conneaut Lake, PA 16316
(814) 382-8840
✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Conneaut Lake Chiropractic, PC's NPI number?

The NPI number for Conneaut Lake Chiropractic, PC is 1396918215. It was assigned to this organization in the NPPES registry on April 11, 2008.

Where is Conneaut Lake Chiropractic, PC located?

Conneaut Lake Chiropractic, PC is located at 13245 Conneaut Lake Rd, Conneaut Lake, PA 16316. The listed phone number is (814) 382-8840.

What is Conneaut Lake Chiropractic, PC's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Is Conneaut Lake Chiropractic, PC enrolled in Medicare?

Yes. Conneaut Lake Chiropractic, PC is registered in the Medicare PECOS enrollment system.

When is Conneaut Lake Chiropractic, PC's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Pennsylvania, Clinic/Group Practice) is due for revalidation by January 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Conneaut Lake Chiropractic, PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Chiropractic) reassigns their Medicare billing to Conneaut Lake Chiropractic, PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Conneaut Lake Chiropractic, PC was last updated on April 11, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.