Individual provider Active NPI

Fred T. Schmidt, D.C.

  • Chiropractor
  • Massapequa, NY
National Provider Identifier
1063504587
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X8396 Issued in NY
Practice address
4150 Merrick Rd Ste D
Massapequa, NY 11758-6028
Phone
(516) 799-8888
Fax
(516) 799-8888
NPI assigned
Sep 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X8396 NY Primary

Addresses

Primary practice location

4150 Merrick Rd Ste D
Massapequa, NY 11758-6028

Mailing address

4150 Merrick Rd Ste D
Massapequa, NY 11758-6028
Phone (516) 799-8888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
X8396NYMDChiropractor
008396NYMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Community Chiropractic and Acupuncture of Park Slope,PLLC PastSince Feb 3, 2019 Accepting new patients

Organizations & group practices 1

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": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063504587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 MERRICK RD STE D",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117586028",
            "telephone_number": "516-799-8888",
            "fax_number": "516-799-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 MERRICK RD STE D",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117586028",
            "telephone_number": "516-799-8888",
            "fax_number": "516-799-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMIDT",
        "first_name": "FRED",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X8396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Massapequa, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.