NPIMap

Organization Active NPI

Monmouth Pain and Rehabilitation PC

  • Chiropractor
  • Red Bank, NJ
National Provider Identifier
1073699385
Registry record updated Feb 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00516600 Issued in NJ
Legal business name
MONMOUTH PAIN AND REHABILITATION PC
Practice address
7 Globe CT
Red Bank, NJ 07701-1824
Phone
(732) 345-1377
Fax
(732) 936-9493
NPI assigned
Oct 29, 2006
Last updated
Feb 20, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2012

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

Authorized official

Name
Dr. Thomas Dandrea, D.C.NPI 1770512188
Title
President
Phone
(732) 345-1377

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 38MC00516600 NJ Primary
Physical Therapy Clinic/Center 261QP2000X

Addresses

Primary practice location

7 Globe CT
Red Bank, NJ 07701-1824

Mailing address

7 Globe CT
Red Bank, NJ 07701-1824
Phone (732) 345-1377

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080501000050 NJ Part B Supplier - Clinic/Group Practice 1557460714 Receives reassigned benefits from 18 practitioners
Practice locations: Wall, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 25

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329696000000",
    "number": "1073699385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 GLOBE CT",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077011824",
            "telephone_number": "732-345-1377",
            "fax_number": "732-936-9493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 GLOBE CT",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077011824",
            "telephone_number": "732-345-1377",
            "fax_number": "732-936-9493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONMOUTH PAIN AND REHABILITATION PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-29",
        "last_updated": "2012-02-20",
        "status": "A",
        "authorized_official_last_name": "DANDREA",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "732-345-1377",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00516600",
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Red Bank, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2012; 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.