Stephen Joseph Pruden, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

X4234-1 Issued in NY

Practice address

55 Bryant Ave
2ND Floor
Roslyn, NY 11576-1137

Phone

(516) 626-3965

Fax

(516) 625-7701

NPI assigned

Jul 31, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Chiropractic

Education

Other, 1984

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Stephen Pruden DC LLC

  • Chiropractor
  • Roslyn, NY
  • NPI 1215032719
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144236019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 BRYANT AVE",
            "address_2": "2ND FLOOR",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "115761137",
            "telephone_number": "516-626-3965",
            "fax_number": "516-625-7701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 BRYANT AVE",
            "address_2": "2ND FLOOR",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "115761137",
            "telephone_number": "516-626-3965",
            "fax_number": "516-625-7701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUDEN",
        "first_name": "STEPHEN",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X4234-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "X4234-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alan Pine, M.S., LMHC, CGP
• Juliet Posner-Earls, OTR
• Mitchell Lloyd Powell
• Preferred Family Footcare of Li PLLC
• Alexander Pearce Prestley, MD
• Francesca Anne Prudente, PA-C
• Kai-Hong Qiu, ACUPUNCTURIST
• Rabbat Extended Management LLC
• Rabbat Medical Practice PC
• Sahar Ahmed Rabbat, PHARM.D

• Chiropractor in Roslyn, NY
• Providers in Roslyn, NY by specialty
• Chiropractor in New York

• 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.