Individual provider Active NPI

James David Fitzgibbon, DC

  • Chiropractor
  • Lindenhurst, NY
National Provider Identifier
1194769620
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X008630 Issued in NY
Practice address
364 S Wellwood Ave
Lindenhurst, NY 11757-4905
Phone
(631) 956-3489
NPI assigned
Jun 15, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X008630 NY Primary

Addresses

Primary practice location

364 S Wellwood Ave
Lindenhurst, NY 11757-4905

Mailing address

435 S 1St St
Lindenhurst, NY 11757-4914
Phone (631) 956-1785

Other identifiers 1

IdentifierTypeStateIssuer
CO8630-8OtherNMWORKERS' COMP

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060720000100 NY Practitioner - Chiropractic 7719990563 Practice locations: Lindenhurst, NY

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

364 S Wellwood Ave
Lindenhurst, NY 11757-4905
Phone (631) 956-3489

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X008630NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Works PC Chiropractor 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1194769620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 S 1ST ST",
            "city": "LINDENHURST",
            "state": "NY",
            "postal_code": "117574914",
            "telephone_number": "631-956-1785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "364 S WELLWOOD AVE",
            "city": "LINDENHURST",
            "state": "NY",
            "postal_code": "117574905",
            "telephone_number": "631-956-3489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZGIBBON",
        "first_name": "JAMES",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X008630",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS' COMP",
            "identifier": "CO8630-8",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lindenhurst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.