Active NPI
Robert Mark Zuckerman, D.C.
- Chiropractor
- Thousand Oaks, CA
National Provider Identifier
1043321854
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC19341
- Practice address
- 3180 Willow LN 112
Thousand Oaks, CA 91361-4983 - Phone
- (805) 494-0550
- Fax
- (805) 494-9751
- NPI assigned
- Aug 31, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC19341 | CA | Primary |
Addresses
Primary practice location
3180 Willow LN 112
Thousand Oaks, CA 91361-4983
Mailing address
3180 Willow LN 112
Thousand Oaks, CA 91361-4983
Phone (805) 494-0550
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 770230670 | Other | CA | TAX ID # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101104000460 | CA | Practitioner - Chiropractic | 7012101967 | Practice locations: Westlake Village, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Cleveland Chiropractic College - Los Angeles, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2393 Townsgate Rd
Suite 102
Thousand Oaks, CA 91361-2513
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19341 | CA | MD | Addiction (Substance Use Disorder) Counselor |
| DC19341 | CA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447113600000",
"number": "1043321854",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3180 WILLOW LN 112",
"city": "THOUSAND OAKS",
"state": "CA",
"postal_code": "913614983",
"telephone_number": "805-494-0550",
"fax_number": "805-494-9751"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3180 WILLOW LN 112",
"city": "THOUSAND OAKS",
"state": "CA",
"postal_code": "913614983",
"telephone_number": "805-494-0550",
"fax_number": "805-494-9751"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZUCKERMAN",
"first_name": "ROBERT",
"middle_name": "MARK",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2015-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC19341",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID #",
"identifier": "770230670",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Thousand Oaks, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2015; 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.