Active NPI
Michael Lawrence Kolin, D.C.
- Chiropractor
- New York, NY
National Provider Identifier
1114089430
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- X009639-1
- Practice address
- 512 Fashion Ave
Suite 1404-a
New York, NY 10018-4603 - Phone
- (212) 768-7979
- Fax
- (212) 768-1223
- NPI assigned
- Dec 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | X009639-1 | NY | Primary |
Addresses
Primary practice location
512 Fashion Ave
Suite 1404-a
New York, NY 10018-4603
Mailing address
18 Frost Pond Dr
Roslyn, NY 11576-2808
Phone (917) 533-3083
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P1946771 | Other | OXFORD HEALTH PLANS | |
| 613941 | Other | UNITED HEALTHCARE | |
| 7654667 | Other | AETNA US HEALTHCARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| X009639-1 | NY | MD | Chiropractor |
| 009639 | NY | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pelham Physical Medicine Inc | Chiropractor | Past | Accepting new patients |
| Pelham Physical Medicine Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Rehabilitation Clinic/Center
- Bronx, NY
- NPI 1952465338
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1114089430",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18 FROST POND DR",
"city": "ROSLYN",
"state": "NY",
"postal_code": "115762808",
"telephone_number": "917-533-3083",
"fax_number": "212-768-1223"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "512 FASHION AVE",
"address_2": "SUITE 1404-A",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100184603",
"telephone_number": "212-768-7979",
"fax_number": "212-768-1223"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOLIN",
"first_name": "MICHAEL",
"middle_name": "LAWRENCE",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NY",
"license": "X009639-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD HEALTH PLANS",
"identifier": "P1946771",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "613941",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA US HEALTHCARE",
"identifier": "7654667",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.