Organization Active NPI

Robyn Croutch D C P C

Doing business as Back to Life Chiropractic

  • Chiropractor
  • Port Washington, NY
National Provider Identifier
1063740215
Registry record updated Aug 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X010011-1 Issued in NY
Legal business name
ROBYN CROUTCH D C P C
Doing business as
Back to Life Chiropractic
Practice address
8 Haven Ave Ste 223
Port Washington, NY 11050-3636
Phone
(516) 754-7118
Fax
(516) 944-9644
NPI assigned
Nov 30, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2025

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

Authorized official

Name
Dr. Robyn P Croutch, D.C.NPI 1861679219
Title
Owner
Phone
(516) 944-4469

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 X010011-1 NY Primary

Addresses

Primary practice location

8 Haven Ave Ste 223
Port Washington, NY 11050-3636

Mailing address

8 Haven Ave Ste 223
Port Washington, NY 11050-3636
Phone (516) 754-7118

Other names 1

  • Back to Life Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250926000888 NY Part B Supplier - Clinic/Group Practice 1254222474 Receives reassigned benefits from 2 practitioners
Practice locations: Port Washington, NY

National Provider Directory

National Provider Directory

Locations

12 Irma Ave
Port Washington, NY 11050
Phone (516) 869-3338

8 Haven Ave
Ste 223
Port Washington, NY 11050
Phone (516) 754-7118

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": "1259539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755388800000",
    "number": "1063740215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 HAVEN AVE STE 223",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110503636",
            "telephone_number": "516-754-7118",
            "fax_number": "516-944-9644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 HAVEN AVE STE 223",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110503636",
            "telephone_number": "516-754-7118",
            "fax_number": "516-944-9644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBYN CROUTCH D C P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-30",
        "last_updated": "2025-08-17",
        "certification_date": "2025-08-17",
        "status": "A",
        "authorized_official_last_name": "CROUTCH",
        "authorized_official_first_name": "ROBYN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-944-4469",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X010011-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Back to Life Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port Washington, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2025; 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.