Individual provider Active NPI

Kaltheen Sue Ann Rebisz, DC,DACRB

  • Rehabilitation Chiropractor
  • Garfield, NJ
National Provider Identifier
1063586881
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
38MC00357600 Issued in NJ
Practice address
430 Midland Avenue
Garfield, NJ 07026-1600
Phone
(973) 772-0411
Fax
(973) 772-4934
NPI assigned
Nov 20, 2006
Sex
Female
Sole proprietor
Yes

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
Rehabilitation Chiropractor 111NR0400X 38MC00357600 NJ Primary

Addresses

Primary practice location

430 Midland Avenue
Garfield, NJ 07026-1600

Mailing address

430 Midland Ave
Garfield, NJ 07026-1600
Phone (973) 772-0411

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130402000472 NJ Practitioner - Chiropractic 4981849569 Reassigns benefits to 1 organization
Practice locations: Garfield, NJ

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

430 Midland Ave
Garfield, NJ 07026-1600
Phone (973) 772-0411

430 Midland Ave Ofc
Garfield, NJ 07026-1600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rebisz Chiropractic LLC Rehabilitation CurrentSince Oct 28, 2017 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": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063586881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 MIDLAND AVE",
            "city": "GARFIELD",
            "state": "NJ",
            "postal_code": "070261600",
            "telephone_number": "973-772-0411",
            "fax_number": "973-772-4934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 MIDLAND AVENUE",
            "city": "GARFIELD",
            "state": "NJ",
            "postal_code": "070261600",
            "telephone_number": "973-772-0411",
            "fax_number": "973-772-4934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REBISZ",
        "first_name": "KALTHEEN",
        "middle_name": "SUE ANN",
        "name_prefix": "Dr.",
        "credential": "DC,DACRB",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "NJ",
            "license": "38MC00357600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garfield, NJ

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.
  • 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.