Individual provider Active NPI

Paul Joseph Roses, DC

  • Chiropractor
  • Bayonne, NJ
National Provider Identifier
1154490803
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2273 Issued in NJ
Practice address
901 Avenue C
Bayonne, NJ 07002-3012
Phone
(201) 339-2226
Fax
(201) 339-2225
NPI assigned
Nov 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 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 2273 NJ Primary

Addresses

Primary practice location

901 Avenue C
Bayonne, NJ 07002-3012

Mailing address

25 Boland Dr
West Orange, NJ 07052-3675
Phone (201) 339-2226

Other identifiers 1

IdentifierTypeStateIssuer
3187209MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120125000052 NJ Practitioner - Chiropractic 1456361526 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1981
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

901 Ave C
Bayonne, NJ 07002-3012
Phone (201) 339-2225

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2273NJMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Midtown Family Chiropractic Center PC CurrentSince Oct 2, 1982 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1154490803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 BOLAND DR",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070523675",
            "telephone_number": "201-339-2226",
            "fax_number": "201-339-7392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 AVENUE C",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070023012",
            "telephone_number": "201-339-2226",
            "fax_number": "201-339-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSES",
        "first_name": "PAUL",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "2273",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3187209",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayonne, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.