Port Jefferson Chiropractic Office PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

X002824 Issued in NY

Legal business name

PORT JEFFERSON CHIROPRACTIC OFFICE PC

Practice address

416 Route 25a
Setauket, NY 11733-3841

Phone

(631) 751-7700

Fax

(631) 751-7096

NPI assigned

Feb 26, 2011

Organization subpart

No

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

Authorized official

Name

Michael Horney, DCNPI 1053310912

Title

Sole Owner of Corporation

Phone

(631) 751-7700

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Sheldon Horney, D.C.

  • Chiropractor
  • Setauket, NY
  • NPI 1053310912
  Medicare reassignment NPD Authorized official
• Elfriede Margot Weiss-Paquette, LCSW

  • Clinical Social Worker
  • W Brentwood, NY
  • NPI 1417010018
  NPD (past)

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

{
    "created_epoch": "1298678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298678400000",
    "number": "1174820120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 ROUTE 25A",
            "city": "SETAUKET",
            "state": "NY",
            "postal_code": "117333841",
            "telephone_number": "631-751-7700",
            "fax_number": "631-751-7096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 ROUTE 25A",
            "city": "SETAUKET",
            "state": "NY",
            "postal_code": "117333841",
            "telephone_number": "631-751-7700",
            "fax_number": "631-751-7096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORT JEFFERSON CHIROPRACTIC OFFICE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-26",
        "last_updated": "2011-02-26",
        "status": "A",
        "authorized_official_last_name": "HORNEY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "SOLE OWNER OF CORPORATION",
        "authorized_official_telephone_number": "631-751-7700",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X002824",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01738370",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Georgeanna Christina Piazza, LMT
• Nicole J Piervencenti, LMHC
• Allison M Pinard, M.A., ATC, EMT-B
• Nicole Paige Polimeni, PA-C
• Kimberly Ann Pope, FNP
• Port Jefferson Emergency Medical Care
• Jeffrey Porte, M.D.
• Joseph J Pulaski
• Evan Rafferty
• Rena Ferguson, MD, PC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2011; 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.