Individual provider Active NPI

Maciek Kolodziejczak, D.C.

  • Chiropractor
  • Cromwell, CT
National Provider Identifier
1285866202
Registry record updated Aug 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
001813 Issued in CT
Practice address
160 West St
Ste C
Cromwell, CT 06416-2441
Phone
(860) 398-5420
Fax
(860) 398-5424
NPI assigned
Aug 10, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 001813 CT Primary

Addresses

Primary practice location

160 West St
Ste C
Cromwell, CT 06416-2441

Mailing address

160 West St
Ste C
Cromwell, CT 06416-2441
Phone (860) 398-5420

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091117000558 CT Practitioner - Chiropractic 1456499102 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aandm Chiropractic, LLCGroup PAC ID 4183775703, 2 clinicians

Practice addresses (Care Compare)

160 W St
Suite C
Cromwell, CT 06416-2441
Phone (860) 398-5420

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001813CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
A&M Chiropractic, LLC Chiropractor CurrentSince Apr 13, 2009 Accepting new patients

Locations

160 West St
Ste C
Cromwell, CT 06416
Phone (860) 316-8951

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1249862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249862400000",
    "number": "1285866202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 WEST ST",
            "address_2": "STE C",
            "city": "CROMWELL",
            "state": "CT",
            "postal_code": "064162441",
            "telephone_number": "860-398-5420",
            "fax_number": "860-398-5424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 WEST ST",
            "address_2": "STE C",
            "city": "CROMWELL",
            "state": "CT",
            "postal_code": "064162441",
            "telephone_number": "860-398-5420",
            "fax_number": "860-398-5424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLODZIEJCZAK",
        "first_name": "MACIEK",
        "name_prefix": "Mr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-08-10",
        "last_updated": "2009-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CT",
            "license": "001813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cromwell, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2009; 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.