Individual provider Active NPI

Vlad Pogildakov, DC

  • Chiropractor
  • Linden, NJ
National Provider Identifier
1174552889
Registry record updated Mar 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00612000 Issued in NJ
Practice address
1201 Deerfield Ter
Linden, NJ 07036-5523
Phone
(646) 546-8701
Fax
(908) 486-3325
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 38MC00612000 NJ Primary

Addresses

Primary practice location

1201 Deerfield Ter
Linden, NJ 07036-5523

Mailing address

2349 Benson Ave
2G
Brooklyn, NY 11214-4351
Phone (917) 318-0784

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38MC00612000NJMDChiropractor
011676NYMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Adult Medical Day Care Corp. of Bayonne Past 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": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206576000000",
    "number": "1174552889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2349 BENSON AVE",
            "address_2": "2G",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112144351",
            "telephone_number": "917-318-0784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 DEERFIELD TER",
            "city": "LINDEN",
            "state": "NJ",
            "postal_code": "070365523",
            "telephone_number": "646-546-8701",
            "fax_number": "908-486-3325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POGILDAKOV",
        "first_name": "VLAD",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2008-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00612000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Linden, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.