Individual provider Active NPI

Leo Abram Staten, D.C.

  • Chiropractor
  • Neptune City, NJ
National Provider Identifier
1063563625
Registry record updated Dec 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00631300 Issued in NJ
Practice address
61 Morris Ave
Neptune City, NJ 07753-6426
Phone
(201) 874-9084
Fax
(973) 695-1933
NPI assigned
Jan 12, 2007
Last updated
Dec 9, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 38MC00631300 NJ Primary

Addresses

Primary practice location

61 Morris Ave
Neptune City, NJ 07753-6426

Mailing address

PO Box 51
Ledgewood, NJ 07852-0051
Phone (201) 874-9084

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041126000016 NJ Practitioner - Chiropractic 8729043153 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

61 Morris Ave
Neptune, NJ 07753-6426
Phone (732) 456-6337

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38MC00631300NJMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Leo a. Staten DC LLC Chiropractor CurrentSince Jul 24, 2015 Accepting new patients
Colts Neck Spine & Joint Care LLC Past Accepting new patients

Locations

61 Morris Ave
Neptune City, NJ 07753
Phone (516) 487-5044

1553 Ruth Rd
Ste 2
North Brunswick, NJ 08902
Phone (267) 987-5510

1279 US Highway 46
Parsippany, NJ 07054
Phone (973) 334-0577

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": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449619200000",
    "number": "1063563625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51",
            "city": "LEDGEWOOD",
            "state": "NJ",
            "postal_code": "078520051",
            "telephone_number": "201-874-9084",
            "fax_number": "973-695-0933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 MORRIS AVE",
            "city": "NEPTUNE CITY",
            "state": "NJ",
            "postal_code": "077536426",
            "telephone_number": "201-874-9084",
            "fax_number": "973-695-1933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STATEN",
        "first_name": "LEO",
        "middle_name": "ABRAM",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-12",
        "last_updated": "2015-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00631300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Neptune City, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 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.

Verify at the official NPI Registry.