Timothy Jude Dieckman, DC
Individual provider Active NPI Chiropractor · Toms River, NJ
NPI 1083766935 · NPPES record last updated Aug 7, 2012
Key facts
- NPI
- 1083766935
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 38NJMC0047700 (NJ)
- Practice address
- 631 Jamaica Blvd
Suite #1
Toms River, NJ 08757-4000 - Phone
- (732) 341-6555
- Fax
- (732) 557-6369
- NPI assigned
- Jan 18, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Life Chiropractic College - West, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
632 Jamaica Blvd
Suite 1
Toms River, NJ 08757
Phone (732) 341-6555
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20031103000015 | NJ | Practitioner - Chiropractic | 5092627794 | Practice locations: Toms River, NJ |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38NJMC0047700 | NJ | MD | Chiropractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 38NJMC0047700 | NJ | Yes |
Addresses
Primary practice location
631 Jamaica Blvd
Suite #1
Toms River, NJ 08757-4000
Mailing address
PO Box 372
Pine Beach, NJ 08741
Phone (732) 341-6555
Other providers in Toms River, NJ
- Kadidiatou Diawara
- Daniel Dicesare
- Frank Patrick Dichiara
- David Brian Dickerson
- William J Didie
- Allison M Dierking
- Geraldine Dierking
- Thomas Dietze
- Jaclyn E Digesere
- William R Dilorenzo
All providers in Toms River, NJ · Chiropractor in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 7, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.