Individual provider Active NPI

John Fernandez, D.C.

  • Orthopedic Chiropractor
  • Woodside, NY
National Provider Identifier
1083734032
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic ChiropractorTaxonomy code 111NX0800X
License
C-007735-6B Issued in NY
Practice address
4322 50TH St
Suite 1-B
Woodside, NY 11377-4442
Phone
(718) 424-4455
Fax
(718) 478-8672
NPI assigned
Mar 30, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Chiropractor 111NN0400X C-007735-6B NY
Sports Physician Chiropractor 111NS0005X C-007735-6B NY
Orthopedic Chiropractor 111NX0800X C-007735-6B NY Primary

Addresses

Primary practice location

4322 50TH St
Suite 1-B
Woodside, NY 11377-4442

Mailing address

1 Pia CT
Hauppauge, NY 11788-3461
Phone (631) 793-2087

Other identifiers 1

IdentifierTypeStateIssuer
1376750OtherNYCIGNA HEALTHCARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140403000679 NY Order and Referring Only - Sports MedicinePractitioner - Sports Medicine 9032340120

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C-007735-6BNYMDOrthopedic Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Healthnet, P.C. Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1083734032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PIA CT",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117883461",
            "telephone_number": "631-793-2087",
            "fax_number": "718-478-8672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4322 50TH ST",
            "address_2": "SUITE 1-B",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113774442",
            "telephone_number": "718-424-4455",
            "fax_number": "718-478-8672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-30",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "NY",
            "license": "C-007735-6B",
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "NY",
            "license": "C-007735-6B",
            "primary": false
        },
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "NY",
            "license": "C-007735-6B",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTHCARE",
            "identifier": "1376750",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodside, NY

Sources for this page

Verify at the official NPI Registry.