Organization Active NPI

Genesis Family Chiropractic, P.C.

  • Rehabilitation Chiropractor
  • Cliffside Park, NJ
National Provider Identifier
1083829154
Registry record updated May 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
38MC00615800 Issued in NJ
Legal business name
GENESIS FAMILY CHIROPRACTIC, P.C.
Practice address
596 Anderson Ave
Suite 104
Cliffside Park, NJ 07010-1831
Phone
(201) 941-8008
Fax
(201) 941-3880
NPI assigned
May 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2008

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

Authorized official

Name
Dr. Feodor A Sakatch, D.C.NPI 1912086398
Title
President
Phone
(201) 941-8008

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
Rehabilitation ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NR0400X 38MC00615800 NJ Primary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 40QA01156300 NJ

Addresses

Primary practice location

596 Anderson Ave
Suite 104
Cliffside Park, NJ 07010-1831

Mailing address

596 Anderson Ave
Suite 104
Cliffside Park, NJ 07010-1831
Phone (201) 941-8008

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090722000332 NJ Part B Supplier - Clinic/Group Practice 0648219980 Receives reassigned benefits from 3 practitioners
Practice locations: Cliffside Park, NJ; Piscataway, NJ

National Provider Directory

National Provider Directory

Locations

820 Broadway
Bayonne, NJ 07002
Phone (201) 437-7070

108 Woodward Rd
Manalapan, NJ 07726
Phone (201) 787-7142

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211846400000",
    "number": "1083829154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "596 ANDERSON AVE",
            "address_2": "SUITE 104",
            "city": "CLIFFSIDE PARK",
            "state": "NJ",
            "postal_code": "070101831",
            "telephone_number": "201-941-8008",
            "fax_number": "201-941-3880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "596 ANDERSON AVE",
            "address_2": "SUITE 104",
            "city": "CLIFFSIDE PARK",
            "state": "NJ",
            "postal_code": "070101831",
            "telephone_number": "201-941-8008",
            "fax_number": "201-941-3880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS FAMILY CHIROPRACTIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-11",
        "last_updated": "2008-05-27",
        "status": "A",
        "authorized_official_last_name": "SAKATCH",
        "authorized_official_first_name": "FEODOR",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-941-8008",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "NJ",
            "license": "38MC00615800",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01156300",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cliffside Park, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2008; 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.