Individual provider Active NPI

Anthony Palumbo

  • Chiropractor
  • S Ozone Park, NY
National Provider Identifier
1225041379
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X08127 Issued in NY
Practice address
13355 Lefferts Blvd
S Ozone Park, NY 11420-3131
Phone
(516) 220-8850
NPI assigned
Aug 13, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X08127 NY Primary
Chiropractor 111N00000X CH8129 FL

Addresses

Primary practice location

13355 Lefferts Blvd
S Ozone Park, NY 11420-3131

Mailing address

2691 Miller Ave
Oceanside, NY 11572-1212
Phone (516) 220-8850

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140709001214 NY Practitioner - Chiropractic 1951531946 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York Chiropractic and Physical Therapy, PLLCGroup PAC ID 9537218482, 7 clinicians

Practice addresses (Care Compare)

1163 Forest Ave
Staten Island, NY 10310-2408
Phone (718) 727-0055

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH8129FLMDChiropractor
X08127NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
New York Chiropractic & Physical Therapy, PLLC Chiropractor CurrentSince Jan 2, 2015 Accepting new patients

Locations

1163 Forest Ave
Staten Island, NY 10310
Phone (718) 727-0055

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": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225041379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2691 MILLER AVE",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115721212",
            "telephone_number": "516-220-8850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13355 LEFFERTS BLVD",
            "city": "S OZONE PARK",
            "state": "NY",
            "postal_code": "114203131",
            "telephone_number": "516-220-8850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALUMBO",
        "first_name": "ANTHONY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X08127",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH8129",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in S Ozone Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.