Individual provider Active NPI

Raymond Milazzo, DO

  • Chiropractor
  • Wyckoff, NJ
National Provider Identifier
1013936459
Registry record updated Oct 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00216200 Issued in NJ
Practice address
1 Godwin Dr
Wyckoff, NJ 07481-2728
Phone
(201) 891-8110
Fax
(201) 847-0548
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 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 38MC00216200 NJ Primary

Addresses

Primary practice location

1 Godwin Dr
Wyckoff, NJ 07481-2728

Mailing address

1 Godwin Dr
Wyckoff, NJ 07481-2728
Phone (201) 891-8110

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040428001400 NJ Practitioner - Chiropractic 2961499199 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1 Godwin Dr
Wyckoff, NJ 07481-2728
Phone (201) 891-8110

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
38MC00216200NJMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Wellness Center of Wyckoff Inc Chiropractor CurrentSince Jan 1, 2006 Accepting new patients

Locations

1 Godwin Dr
Wyckoff, NJ 07481
Phone (201) 891-8110

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193616000000",
    "number": "1013936459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GODWIN DR",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "074812728",
            "telephone_number": "201-891-8110",
            "fax_number": "201-847-0548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GODWIN DR",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "074812728",
            "telephone_number": "201-891-8110",
            "fax_number": "201-847-0548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILAZZO",
        "first_name": "RAYMOND",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2007-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00216200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyckoff, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 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.