Organization Active NPI

Dagostino Chiropractic & Associates, PC

  • Sports Physician Chiropractor
  • Garfield, NJ
National Provider Identifier
1124195425
Registry record updated Jun 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
38MC00541800 Issued in NJ
Legal business name
DAGOSTINO CHIROPRACTIC & ASSOCIATES, PC
Practice address
96 Manner Ave
Garfield, NJ 07026-1418
Phone
(973) 772-0099
Fax
(973) 772-0099
NPI assigned
Nov 29, 2006
Last updated
Jun 8, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2010

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

Authorized official

Name
Dr. Dominick Anthony Dagostino Jr., D.C.NPI 1972670271
Title
Doctor
Phone
(973) 772-0099

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X 38MC00541800 NJ Primary

Addresses

Primary practice location

96 Manner Ave
Garfield, NJ 07026-1418

Mailing address

96 Manner Ave
Garfield, NJ 07026-1418
Phone (973) 772-0099

Other identifiers 1

IdentifierTypeStateIssuer
7971907MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081023000534 NJ Part B Supplier - Clinic/Group Practice 8820156656 Receives reassigned benefits from 1 practitioner
Practice locations: Garfield, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275955200000",
    "number": "1124195425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 MANNER AVE",
            "city": "GARFIELD",
            "state": "NJ",
            "postal_code": "070261418",
            "telephone_number": "973-772-0099",
            "fax_number": "973-772-0099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 MANNER AVE",
            "city": "GARFIELD",
            "state": "NJ",
            "postal_code": "070261418",
            "telephone_number": "973-772-0099",
            "fax_number": "973-772-0099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAGOSTINO CHIROPRACTIC & ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2010-06-08",
        "status": "A",
        "authorized_official_last_name": "DAGOSTINO",
        "authorized_official_first_name": "DOMINICK",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "973-772-0099",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "NJ",
            "license": "38MC00541800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7971907",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garfield, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2010; 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.