Individual provider Active NPI

Spencer Corbin, DC

  • Chiropractor
  • Midland Park, NJ
National Provider Identifier
1033794532
Registry record updated May 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00779900 Issued in NJ
Practice address
12 Goffle Rd
Midland Park, NJ 07432-1815
Phone
(844) 777-0910
Fax
(201) 560-0712
NPI assigned
Mar 16, 2021
Last updated
May 11, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 38MC00779900 NJ Primary

Addresses

Primary practice location

12 Goffle Rd
Midland Park, NJ 07432-1815

Mailing address

784 Franklin Ave Ste 250
Franklin Lakes, NJ 07417-1306
Phone (844) 777-0910

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210324001647 NJ Practitioner - Chiropractic 4284041948 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kayal Medical Group, LLCGroup PAC ID 2961894019, 76 clinicians

Practice addresses (Care Compare)

260 Old Hook Rd
Suite 401
Westwood, NJ 07675-3123
Phone (844) 777-0910

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38MC00779900NJMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Kayal Orthopaedic Center, P.C. CurrentSince Apr 1, 2021 Accepting new patients
Kayal Medical Group, LLC Chiropractor CurrentSince Jan 1, 2022 Accepting new patients

Locations

784 Franklin Ave
Ste 250
Franklin Lks, NJ 07417
Phone (201) 560-0711

12 Goffle Rd
Midland Park, NJ 07432
Phone (201) 447-2570

185 N Route 17
Ste 101
Paramus, NJ 07652
Phone (201) 560-0711

7 E Main St
Ramsey, NJ 07446
Phone (201) 327-1400

543 45th St
Union City, NJ 07087
Phone (201) 662-5437

260 Old Hook Rd
Ste 401
Westwood, NJ 07675
Phone (201) 560-0711

529 Goffle Rd
Wyckoff, NJ 07481
Phone (201) 652-1010

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/13982/brand/1/csg/1/fhir/r4
  • Direct secure messaging: spencer.corbin@ko.eclinicaldirectplus.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1615852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652227200000",
    "number": "1033794532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "784 FRANKLIN AVE STE 250",
            "city": "FRANKLIN LAKES",
            "state": "NJ",
            "postal_code": "074171306",
            "telephone_number": "844-777-0910",
            "fax_number": "201-560-0712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 GOFFLE RD",
            "city": "MIDLAND PARK",
            "state": "NJ",
            "postal_code": "074321815",
            "telephone_number": "844-777-0910",
            "fax_number": "201-560-0712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORBIN",
        "first_name": "SPENCER",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-16",
        "last_updated": "2022-05-11",
        "certification_date": "2022-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00779900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland Park, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2022; 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.