Organization Active NPI

West Side Comprehensive Chiropractic Care PC

  • Chiropractor
  • New York, NY
National Provider Identifier
1205040730
Registry record updated Feb 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X006900-1 Issued in NY
Legal business name
WEST SIDE COMPREHENSIVE CHIROPRACTIC CARE PC
Practice address
330 West 58 Street
Suite 407
New York, NY 10019
Phone
(212) 765-6470
NPI assigned
May 10, 2007
Last updated
Feb 28, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2013

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

Authorized official

Name
Michael WatinsNPI 1396856142
Title
Owner
Phone
(212) 765-6470

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X X006900-1 NY Primary

Addresses

Primary practice location

330 West 58 Street
Suite 407
New York, NY 10019

Mailing address

330 West 58 Street
Suite 407
New York, NY 10019

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130225000131 NY Part B Supplier - Clinic/Group Practice 7214182252 Receives reassigned benefits from 1 practitioner
Practice locations: New York, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362009600000",
    "number": "1205040730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 WEST 58 STREET",
            "address_2": "SUITE 407",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 WEST 58 STREET",
            "address_2": "SUITE 407",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10019",
            "telephone_number": "212-765-6470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST SIDE COMPREHENSIVE CHIROPRACTIC CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-10",
        "last_updated": "2013-02-28",
        "status": "A",
        "authorized_official_last_name": "WATINS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "212-765-6470"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X006900-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2013; 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.