Individual provider Active NPI

Jason Brattner, DC

  • Chiropractor
  • Ridgewood, NY
National Provider Identifier
1053486167
Registry record updated May 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X008612 Issued in NY
Practice address
865 Cypress Ave
Ridgewood, NY 11385-4724
Phone
(718) 628-5300
NPI assigned
Nov 22, 2006
Last updated
May 27, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X008612 NY Primary

Addresses

Primary practice location

865 Cypress Ave
Ridgewood, NY 11385-4724

Mailing address

865 Cypress Ave
Ridgewood, NY 11385-4724
Phone (718) 628-5300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040205001019 NY Practitioner - Chiropractic 3779476452 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Queens Chiropractic Associates, PCGroup PAC ID 8022296409, 2 clinicians

Practice addresses (Care Compare)

118 Crescent LN
Roslyn Heights, NY 11577-1552
Phone (516) 626-1305

865 Cypress Ave
Ridgewood, NY 11385-4724
Phone (718) 628-5300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X008612NYMDChiropractor
008612NYMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Queens Chiropractic and Physical Therapy PLLC Chiropractor Current Accepting new patients
Queens Chiropractic Associates, PC Chiropractor CurrentSince Apr 26, 2011 Accepting new patients
Jason S. Brattner, DC, PC Chiropractor PastSince Jun 30, 2000 Accepting new patients

Locations

865 Cypress Ave
Ridgewood, NY 11385
Phone (718) 381-0167

Organizations & group practices 4

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": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211846400000",
    "number": "1053486167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "865 CYPRESS AVE",
            "city": "RIDGEWOOD",
            "state": "NY",
            "postal_code": "113854724",
            "telephone_number": "718-628-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "865 CYPRESS AVE",
            "city": "RIDGEWOOD",
            "state": "NY",
            "postal_code": "113854724",
            "telephone_number": "718-628-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRATTNER",
        "first_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-22",
        "last_updated": "2008-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X008612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgewood, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2008; 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.