Michael Roman Czupak, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

38MC00628700 Issued in NJ

Practice address

1037 Route 46 Ste 203
Clifton, NJ 07013-2459

Phone

(973) 812-0202

Fax

(973) 812-0505

NPI assigned

May 30, 2006

Last updated

Sep 27, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Chiropractic

Education

Logan College of Chiropractic, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Northeastern Spinal Health and Rehabilitation LLC

  • Chiropractor
  • Clifton, NJ
  • NPI 1265463830
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664236800000",
    "number": "1205883600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1037 ROUTE 46 STE 203",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070132459",
            "telephone_number": "973-812-0202",
            "fax_number": "973-812-0505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1037 ROUTE 46 STE 203",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070132459",
            "telephone_number": "973-812-0202",
            "fax_number": "973-812-0505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CZUPAK",
        "first_name": "MICHAEL",
        "middle_name": "ROMAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-30",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00628700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0637432",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "2577448",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NJ HEALTH PROVIDER",
            "identifier": "60192386",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMBLEM HEALTH PROVIDER",
            "identifier": "1748300P",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Clifton, NJ
• Providers in Clifton, NJ by specialty
• Chiropractor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2022; 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.