Mystic Spine & Sport LLC
NPI 1952692592 · Chiropractor · Mystic, CT
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Mystic Spine & Sport LLC is a Chiropractor organization in Mystic, CT (NPI 1952692592).
Provider details
- NPI number
- 1952692592
- Entity type
- Organization
- Primary specialty
- ChiropractorChiropractic Providers
- Organization subpart
- No
- Authorized official
- Tyler Page, Owner/Doctor(860) 245-4620
Specialties & taxonomies
Chiropractic Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
15 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2011-05-01
- Last updated
- 2024-02-02
- Certified
- 2024-02-02
Frequently asked questions
- What is Mystic Spine & Sport LLC's NPI number?
- Mystic Spine & Sport LLC's National Provider Identifier (NPI) is 1952692592, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Mystic Spine & Sport LLC?
- Mystic Spine & Sport LLC is classified in the NPPES registry as Chiropractor (Chiropractic Providers).
- Where is Mystic Spine & Sport LLC located?
- Mystic Spine & Sport LLC's practice location on file with NPPES is 12 Coogan Blvd Ste 204, Mystic, CT 06355-1938.
- What is Mystic Spine & Sport LLC's phone number?
- The practice phone number listed in the NPPES registry for Mystic Spine & Sport LLC is (860) 245-4620.
- Does Mystic Spine & Sport LLC accept Medicare?
- Mystic Spine & Sport LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Mystic Spine & Sport LLC?
- The authorized official listed on Mystic Spine & Sport LLC's NPPES record is Tyler Page, Owner/Doctor. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Mystic Spine & Sport LLC's NPI active?
- Yes — Mystic Spine & Sport LLC's NPI (1952692592) is active in the NPPES registry as of the last update on 2024-02-02.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.