Wayne M Poller, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

38MC00208200 Issued in NJ

Practice address

136 N Washington Avenue
103
Bergenfield, NJ 07621

Phone

(201) 387-2800

Fax

(201) 387-2248

NPI assigned

Dec 9, 2005

Last updated

Feb 4, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Chiropractic

Education

New York Chiropractic College, 1980

Medicare assignment

May accept Medicare assignment

Group practices

Bergen Spine and Rehabilitation, LLCGroup PAC ID 2163528498, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bergen Spine & Rehabilitation, LLC

  • Occupational Health Chiropractor
  • Bergenfield, NJ
  • NPI 1992804868
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1134086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233705600000",
    "number": "1083699292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 N WASHINGTON AVENUE",
            "address_2": "103",
            "city": "BERGENFIELD",
            "state": "NJ",
            "postal_code": "07621",
            "telephone_number": "201-387-2800",
            "fax_number": "201-387-2248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 N WASHINGTON AVENUE",
            "address_2": "103",
            "city": "BERGENFIELD",
            "state": "NJ",
            "postal_code": "07621",
            "telephone_number": "201-387-2800",
            "fax_number": "201-387-2248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLER",
        "first_name": "WAYNE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-09",
        "last_updated": "2009-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00208200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "350055367",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0023792",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Desiree Polonia, LMHC
• Karen Ponce
• Post at Home LLC
• Premier Oral Surgery of Bergen County PC
• Mijanou Shakira President

• Chiropractor in Bergenfield, NJ
• Providers in Bergenfield, NJ by specialty
• Chiropractor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2009; 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.