Individual provider Active NPI

Warren Craig Jacoby, D.C

  • Chiropractor
  • Ridgewood, NJ
National Provider Identifier
1285879841
Registry record updated Dec 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00504200 Issued in NJ
Practice address
286 Lincoln Ave
Ridgewood, NJ 07450-4921
Phone
(201) 652-5333
Fax
(201) 652-1165
NPI assigned
Dec 11, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 38MC00504200 NJ Primary

Addresses

Primary practice location

286 Lincoln Ave
Ridgewood, NJ 07450-4921

Mailing address

286 Lincoln Ave
Ridgewood, NJ 07450-4921
Phone (201) 652-5333

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090916000704 NJ Practitioner - Chiropractic 3577619519 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stephen a Jones LLCGroup PAC ID 3971601394, 6 clinicians

Practice addresses (Care Compare)

18 Wyckoff Ave
Suite 201
Waldwick, NJ 07463-1778
Phone (201) 447-5757

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Stephen a. Jones, L.L.C. Chiropractor CurrentSince Sep 1, 2018 Accepting new patients

Locations

18 Wyckoff Ave
Ste 201
Waldwick, NJ 07463
Phone (201) 447-5757

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": "1228953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228953600000",
    "number": "1285879841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "286 LINCOLN AVE",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074504921",
            "telephone_number": "201-652-5333",
            "fax_number": "201-652-1165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "286 LINCOLN AVE",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074504921",
            "telephone_number": "201-652-5333",
            "fax_number": "201-652-1165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBY",
        "first_name": "WARREN",
        "middle_name": "CRAIG",
        "credential": "D.C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-11",
        "last_updated": "2008-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00504200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2008; 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.