Organization Active NPI

Nussbaum Chiropractic PLLC

  • Radiology Chiropractor
  • Albany, NY
National Provider Identifier
1124555024
Registry record updated Aug 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology ChiropractorTaxonomy code 111NR0200X
License
005850 Issued in NY
Legal business name
NUSSBAUM CHIROPRACTIC PLLC
Practice address
130 Everett Rd
Albany, NY 12205-1418
Phone
(518) 482-6175
Fax
(518) 459-5134
NPI assigned
May 23, 2017
Organization subpart
Yes
Parent organization
NUSSBAUM CHIROPRACTIC PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 7, 2024

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

Authorized official

Name
Mary Messia-McBride
Title
Office Manager
Phone
(518) 482-6175

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NR0200X 005850 NY Primary
Radiology ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NR0200X X007262-3 NY
Massage TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225700000X 026404-1 NY

Addresses

Primary practice location

130 Everett Rd
Albany, NY 12205-1418

Mailing address

130 Everett Rd
Albany, NY 12205-1418
Phone (518) 482-6175

Other identifiers 2

IdentifierTypeStateIssuer
1447383369OtherNYNPI
1437192820OtherNYNPI

Other names 1

  • KEITH S NUSSBAUM Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190404002786 NY Part B Supplier - Clinic/Group Practice 1052652815 Receives reassigned benefits from 3 practitioners
Practice locations: Albany, NY

National Provider Directory

National Provider Directory
Part of
Nussbaum Chiropractic PLLC

Practitioners & affiliated clinicians

Practitioners 4

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": "1495497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722988800000",
    "number": "1124555024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 EVERETT RD",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122051418",
            "telephone_number": "518-482-6175",
            "fax_number": "518-459-5134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 EVERETT RD",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122051418",
            "telephone_number": "518-482-6175",
            "fax_number": "518-459-5134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUSSBAUM CHIROPRACTIC PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NUSSBAUM CHIROPRACTIC PLLC",
        "enumeration_date": "2017-05-23",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A",
        "authorized_official_last_name": "MESSIA-MCBRIDE",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "518-482-6175"
    },
    "taxonomies": [
        {
            "code": "111NR0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Radiology",
            "state": "NY",
            "license": "005850",
            "primary": true
        },
        {
            "code": "111NR0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Radiology",
            "state": "NY",
            "license": "X007262-3",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "026404-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1447383369",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1437192820",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KEITH S NUSSBAUM",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Albany, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2024; 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.