Individual provider Active NPI

Robert Seth Exelbert, D.C.

  • Chiropractor
  • Hyde Park, NY
National Provider Identifier
1194816561
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X002426 Issued in NY
Practice address
4311 Albany Post Rd
Hyde Park, NY 12538-3601
Phone
(845) 229-8868
Fax
(845) 229-1276
NPI assigned
Sep 28, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X002426 NY Primary

Addresses

Primary practice location

4311 Albany Post Rd
Hyde Park, NY 12538-3601

Mailing address

4311 Albany Post Rd
Hyde Park, NY 12538-3601
Phone (845) 229-8868

Other identifiers 10

IdentifierTypeStateIssuer
5898349OtherNYGHI PPO
915107OtherNYACN
0030711OtherNYGHI
P402988OtherNYOXFORD
10025591OtherNYCDPHP
X14861OtherNYBC/BS BLUECHOICE
1C8656OtherNYHEALTHNET
50119OtherNYPRISM
9155107OtherNYUNITED HEALTHCARE
93783OtherNYMVP

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120103000775 NY Practitioner - Chiropractic 4284800897 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X002426NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Brewster Chiropractic PLLC Chiropractor CurrentSince Nov 2, 2015 Accepting new patients

Locations

4311 Albany Post Rd
Hyde Park, NY 12538
Phone (845) 229-8868

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": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1194816561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4311 ALBANY POST RD",
            "city": "HYDE PARK",
            "state": "NY",
            "postal_code": "125383601",
            "telephone_number": "845-229-8868",
            "fax_number": "845-229-1276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4311 ALBANY POST RD",
            "city": "HYDE PARK",
            "state": "NY",
            "postal_code": "125383601",
            "telephone_number": "845-229-8868",
            "fax_number": "845-229-1276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EXELBERT",
        "first_name": "ROBERT",
        "middle_name": "SETH",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X002426",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI PPO",
            "identifier": "5898349",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACN",
            "identifier": "915107",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0030711",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P402988",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPHP",
            "identifier": "10025591",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS BLUECHOICE",
            "identifier": "X14861",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "1C8656",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRISM",
            "identifier": "50119",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "9155107",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "93783",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hyde Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.