Individual provider Active NPI

Muriel Fortune, CHIROPRACTOR

  • Chiropractor
  • Freeport, NY
National Provider Identifier
1023514510
Registry record updated Apr 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X012971 Issued in NY
Practice address
31 Guy Lombardo Ave
Freeport, NY 11520-3632
Phone
(516) 213-4610
NPI assigned
Apr 3, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X012971 NY Primary

Addresses

Primary practice location

31 Guy Lombardo Ave
Freeport, NY 11520-3632

Mailing address

702 John St
North Baldwin, NY 11510-1811

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200813002320 NY Practitioner - Chiropractic 1456777002 Reassigns benefits to 3 organizations
Practice locations: North Baldwin, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X012971NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Rehabilitation, PC CurrentSince Sep 21, 2020 Accepting new patients
Our Gentle Touch Chiropractic of the Bronx, P.C. Chiropractor CurrentSince Sep 21, 2020 Accepting new patients
Our Gentle Touch Chiropractic, PC Chiropractor CurrentSince Sep 21, 2020 Accepting new patients
Freeport Pain Managment PC. Past Accepting new patients
Walter E. Mendoza Chiropractor, P.C PastSince May 27, 2017 Accepting new patients

Locations

2000 E Gun Hill Rd
Bronx, NY 10469
Phone (718) 320-0400

1740 84th St
Brooklyn, NY 11214
Phone (718) 232-3666

68 Hauppauge Rd
Commack, NY 11725
Phone (631) 499-6500

8 Bond St
Ste 201
Great Neck, NY 11021

Organizations & group practices 5

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": "1522713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522713600000",
    "number": "1023514510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 JOHN ST",
            "city": "NORTH BALDWIN",
            "state": "NY",
            "postal_code": "115101811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 GUY LOMBARDO AVE",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115203632",
            "telephone_number": "516-213-4610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTUNE",
        "first_name": "MURIEL",
        "credential": "CHIROPRACTOR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-03",
        "last_updated": "2018-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X012971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freeport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2018; 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.