Organization Active NPI

Advanced Chiropractic and Wellness Center

  • Chiropractor
  • South Plainfield, NJ
National Provider Identifier
1023105236
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00422600 Issued in NJ
Legal business name
ADVANCED CHIROPRACTIC AND WELLNESS CENTER
Practice address
904 Oak Tree Ave
Suite 904
South Plainfield, NJ 07080-5126
Phone
(908) 561-1777
Fax
(908) 561-9711
NPI assigned
Oct 7, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Norayr Ozbalik, D.C.NPI 1861432684
Title
President
Phone
(908) 561-1777

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 38MC00422600 NJ Primary

Addresses

Primary practice location

904 Oak Tree Ave
Suite 904
South Plainfield, NJ 07080-5126

Mailing address

904 Oak Tree Ave
Suite 904
South Plainfield, NJ 07080-5126
Phone (908) 561-1777

Other identifiers 6

IdentifierTypeStateIssuer
217333OtherNJUHC
0066109MedicaidNJ
20820140000OtherNJAMERIHEALTH
2381661OtherNJAETNA
P1885364OtherNJOXFORD
X8Z38OtherNJWELLCHOICE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120305000333 NJ Part B Supplier - Clinic/Group Practice 2062671480 Receives reassigned benefits from 2 practitioners
Practice locations: Edison, NJ

National Provider Directory

National Provider Directory

Locations

3840 Park Ave
Ste D108
Edison, NJ 08820
Phone (723) 902-2302

904 Oak Tree Ave
Ste 0
South Plainfield, NJ 07080
Phone (908) 561-1777

904 Oak Tree Ave
Ste 904
South Plainfield, NJ 07080
Phone (908) 561-1777

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1160179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023105236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 OAK TREE AVE",
            "address_2": "SUITE 904",
            "city": "SOUTH PLAINFIELD",
            "state": "NJ",
            "postal_code": "070805126",
            "telephone_number": "908-561-1777",
            "fax_number": "908-561-9711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 OAK TREE AVE",
            "address_2": "SUITE 904",
            "city": "SOUTH PLAINFIELD",
            "state": "NJ",
            "postal_code": "070805126",
            "telephone_number": "908-561-1777",
            "fax_number": "908-561-9711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED CHIROPRACTIC AND WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "OZBALIK",
        "authorized_official_first_name": "NORAYR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "908-561-1777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00422600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "217333",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0066109",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "20820140000",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2381661",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P1885364",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCHOICE",
            "identifier": "X8Z38",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Plainfield, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.