Organization Active NPI

Jonathan Michael DCPC

  • Chiropractor
  • Rockville Centre, NY
National Provider Identifier
1043689714
Registry record updated Sep 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X011832-2 Issued in NY
Legal business name
JONATHAN MICHAEL DCPC
Practice address
55 Maple Ave Ste 306
Rockville Centre, NY 11570-4267
Phone
(516) 705-8836
Fax
(516) 705-8836
NPI assigned
Sep 23, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2015

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

Authorized official

Name
Dr. Jonathan Michael, DCNPI 1356673537
Title
Owner
Phone
(516) 639-4925

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X X011832-2 NY Primary

Addresses

Primary practice location

55 Maple Ave Ste 306
Rockville Centre, NY 11570-4267

Mailing address

11 Vernon CT
Rockville Centre, NY 11570-5400
Phone (516) 705-8836

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170615000574 NY Part B Supplier - Clinic/Group Practice 3173891140 Receives reassigned benefits from 1 practitioner
Practice locations: Rockville Centre, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1442966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442966400000",
    "number": "1043689714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 VERNON CT",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115705400",
            "telephone_number": "516-705-8836",
            "fax_number": "516-705-8836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 MAPLE AVE STE 306",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115704267",
            "telephone_number": "516-705-8836",
            "fax_number": "516-705-8836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JONATHAN MICHAEL DCPC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-23",
        "last_updated": "2015-09-23",
        "status": "A",
        "authorized_official_last_name": "MICHAEL",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-639-4925",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X011832-2",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville Centre, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2015; 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.