Active NPI
Gregg Ronald Scudero, DC
- Chiropractor
- Brooklyn, NY
National Provider Identifier
1073590741
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- X0069801
- Practice address
- 5912 Flatlands Ave
Brooklyn, NY 11234-1808 - Phone
- (718) 444-8500
- Fax
- (718) 444-8505
- NPI assigned
- Dec 23, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | X0069801 | NY | Primary |
Addresses
Primary practice location
5912 Flatlands Ave
Brooklyn, NY 11234-1808
Mailing address
5912 Flatlands Ave
Brooklyn, NY 11234-1808
Phone (718) 444-8500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| C069809W | Other | WORKERS COMP |
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
| License | State | Type | Specialty |
|---|---|---|---|
| X0069801 | NY | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135296000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1235606400000",
"number": "1073590741",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5912 FLATLANDS AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112341808",
"telephone_number": "718-444-8500",
"fax_number": "718-444-8505"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5912 FLATLANDS AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112341808",
"telephone_number": "718-444-8500",
"fax_number": "718-444-8505"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCUDERO",
"first_name": "GREGG",
"middle_name": "RONALD",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-12-23",
"last_updated": "2009-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NY",
"license": "X0069801",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WORKERS COMP",
"identifier": "C069809W",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.