Active NPI
Michael Nelin, DC
- Chiropractor
- Coram, NY
National Provider Identifier
1073659850
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- X009263-1
- Practice address
- 1970 Route 112 Ste 6
Coram, NY 11727-2300 - Phone
- (631) 451-1515
- Fax
- (631) 451-1616
- NPI assigned
- Jan 29, 2007
- 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 | X009263-1 | NY | Primary |
Addresses
Primary practice location
1970 Route 112 Ste 6
Coram, NY 11727-2300
Mailing address
1970 Route 112 Ste 6
Coram, NY 11727-2300
Phone (631) 451-1515
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3560042-001 | Other | NY | CIGNA |
| 5899463 | Other | NY | GHI |
| SF0003053 | Other | NY | SELECTPRO |
| 95674 | Other | NY | VYTRA |
| AA50689A | Other | NY | MDNY |
| P2174322 | Other | NY | OXFORD |
| 7918040 | Other | NY | AETNA |
| 990089 | Other | NY | EMPIRE HEIRTAGE |
| X7B15 | Other | NY | EMPIRE BCBS |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| X009263-1 | NY | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1073659850",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1970 ROUTE 112 STE 6",
"city": "CORAM",
"state": "NY",
"postal_code": "117272300",
"telephone_number": "631-451-1515",
"fax_number": "631-451-1616"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1970 ROUTE 112 STE 6",
"city": "CORAM",
"state": "NY",
"postal_code": "117272300",
"telephone_number": "631-451-1515",
"fax_number": "631-451-1616"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELIN",
"first_name": "MICHAEL",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NY",
"license": "X009263-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "3560042-001",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI",
"identifier": "5899463",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SELECTPRO",
"identifier": "SF0003053",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VYTRA",
"identifier": "95674",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MDNY",
"identifier": "AA50689A",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD",
"identifier": "P2174322",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7918040",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE HEIRTAGE",
"identifier": "990089",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE BCBS",
"identifier": "X7B15",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Coram, 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.