Individual provider Active NPI

Jerry Michael Mendez, DC

  • Chiropractor
  • Hackensack, NJ
National Provider Identifier
1194746859
Registry record updated Apr 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00647800 Issued in NJ
Practice address
141 Lincoln St
Hackensack, NJ 07601-2934
Phone
(201) 965-0534
Fax
(201) 343-0023
NPI assigned
Jul 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 38MC00647800 NJ Primary

Addresses

Primary practice location

141 Lincoln St
Hackensack, NJ 07601-2934

Mailing address

141 Lincoln St
Hackensack, NJ 07601-2934
Phone (201) 965-0534

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060915000469 NJ Practitioner - Chiropractic 5193720639 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 2005
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

141 Lincoln St
Hackensack, NJ 07601-2934
Phone (201) 965-0534

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Precision Family Health, P.C. Chiropractor CurrentSince May 18, 2016 Accepting new patients
Diego Ruiz DC LLC Chiropractor PastSince Oct 1, 2006 Accepting new patients

Organizations & group practices 3

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": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492992000000",
    "number": "1194746859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 LINCOLN ST",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076012934",
            "telephone_number": "201-965-0534",
            "fax_number": "201-343-0023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 LINCOLN ST",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076012934",
            "telephone_number": "201-965-0534",
            "fax_number": "201-343-0023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDEZ",
        "first_name": "JERRY",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2017-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00647800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2017; 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.