Organization Active NPI

Plaza Chiropractic and Sports Medicine PC

  • Chiropractor
  • Old Bridge, NJ
National Provider Identifier
1205442118
Registry record updated Jan 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
PLAZA CHIROPRACTIC AND SPORTS MEDICINE PC
Practice address
1314 Englishtown Rd
Old Bridge, NJ 08857-1580
Phone
(732) 723-0023
Fax
(732) 723-1614
NPI assigned
Sep 17, 2020
Last updated
Jan 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2022

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

Authorized official

Name
Charles Marotta, DCNPI 1992278881
Title
Owner
Phone
(732) 723-0023

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
Chiropractor 111N00000X Primary

Addresses

Primary practice location

1314 Englishtown Rd
Old Bridge, NJ 08857-1580

Mailing address

1314 Englishtown Rd
Old Bridge, NJ 08857-1580
Phone (732) 723-0023

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201104000189 NJ Part B Supplier - Clinic/Group Practice 0042620908 Receives reassigned benefits from 1 practitioner
Practice locations: Old Bridge, NJ

National Provider Directory

National Provider Directory

Locations

1314 Englishtown Rd
Old Bridge, NJ 08857
Phone (614) 607-1269

Practitioners & affiliated clinicians

Practitioners 4

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": "1600300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642723200000",
    "number": "1205442118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1314 ENGLISHTOWN RD",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088571580",
            "telephone_number": "732-723-0023",
            "fax_number": "732-723-1614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1314 ENGLISHTOWN RD",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088571580",
            "telephone_number": "732-723-0023",
            "fax_number": "732-723-1614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLAZA CHIROPRACTIC AND SPORTS MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-17",
        "last_updated": "2022-01-21",
        "certification_date": "2022-01-21",
        "status": "A",
        "authorized_official_last_name": "MAROTTA",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-723-0023",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Bridge, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2022; 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.