Individual provider Active NPI

Jack Zangara, D.C.

  • Chiropractor
  • East Setauket, NY
National Provider Identifier
1174986178
Registry record updated Mar 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X012802 Issued in NY
Practice address
384 Mark Tree Rd
East Setauket, NY 11733-1002
Phone
(631) 561-5185
NPI assigned
Mar 29, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X012802 NY Primary

Addresses

Primary practice location

384 Mark Tree Rd
East Setauket, NY 11733-1002

Mailing address

24 Griffen CT
Miller Place, NY 11764-1432
Phone (631) 561-5185

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190312003220 NY Practitioner - Chiropractic 8123368040 Practice locations: Port Jefferson Station, NY

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9 Roosevelt Ave
Suite a
Port Jefferson Station, NY 11776-3388
Phone (631) 473-8182

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X012802NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Sophia a Argeropoulos DC PC Chiropractor PastSince Feb 21, 1992 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": "1459209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459209600000",
    "number": "1174986178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 GRIFFEN CT",
            "city": "MILLER PLACE",
            "state": "NY",
            "postal_code": "117641432",
            "telephone_number": "631-561-5185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "384 MARK TREE RD",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117331002",
            "telephone_number": "631-561-5185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZANGARA",
        "first_name": "JACK",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-29",
        "last_updated": "2016-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X012802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Setauket, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2016; 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.