Individual provider Active NPI

John Panicali, D.C.

  • Chiropractor
  • Colts Neck, NJ
National Provider Identifier
1265436646
Registry record updated Aug 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00428800 Issued in NJ
Practice address
420 Route 34 Ste 331
Colts Neck, NJ 07722-2517
Phone
(324) 620-0497
Fax
(324) 620-0597
NPI assigned
Jun 13, 2005
Last updated
Aug 3, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 38MC00428800 NJ Primary
Chiropractor 111N00000X X4379 NY

Addresses

Primary practice location

420 Route 34 Ste 331
Colts Neck, NJ 07722-2517

Mailing address

420 Route 34 Ste 331
Colts Neck, NJ 07722-2517
Phone (732) 462-0049

Other identifiers 1

IdentifierTypeStateIssuer
C043796WOtherNYWC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X4379NYMDChiropractor

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": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596412800000",
    "number": "1265436646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 ROUTE 34 STE 331",
            "city": "COLTS NECK",
            "state": "NJ",
            "postal_code": "077222517",
            "telephone_number": "732-462-0049",
            "fax_number": "718-462-0059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 ROUTE 34 STE 331",
            "city": "COLTS NECK",
            "state": "NJ",
            "postal_code": "077222517",
            "telephone_number": "324-620-0497",
            "fax_number": "324-620-0597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANICALI",
        "first_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00428800",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X4379",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WC",
            "identifier": "C043796W",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colts Neck, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.