Individual provider Active NPI

Michael Robert Guadagnino III, DC

  • Chiropractor
  • Ramsey, NJ
National Provider Identifier
1114149200
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
MC01452 Issued in NJ
Practice address
161 N Franklin Tpke
Ramsey, NJ 07446-1649
Phone
(201) 825-6601
Fax
(202) 825-0226
NPI assigned
May 2, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X MC01452 NJ Primary

Addresses

Primary practice location

161 N Franklin Tpke
Ramsey, NJ 07446-1649

Mailing address

161 N Franklin Tpke
Ramsey, NJ 07446-1649
Phone (201) 825-6601

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120517000226 NJ Practitioner - Chiropractic 8729241484 Practice locations: Ramsey, NJ

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

161 N Franklin Tpke
Ramsey, NJ 07446-1649
Phone (201) 825-6601

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MC01452NJMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114149200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 N FRANKLIN TPKE",
            "city": "RAMSEY",
            "state": "NJ",
            "postal_code": "074461649",
            "telephone_number": "201-825-6601",
            "fax_number": "202-825-0226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 N FRANKLIN TPKE",
            "city": "RAMSEY",
            "state": "NJ",
            "postal_code": "074461649",
            "telephone_number": "201-825-6601",
            "fax_number": "202-825-0226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUADAGNINO",
        "first_name": "MICHAEL",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "MC01452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ramsey, NJ

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.
  • 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.