Individual provider Active NPI

Ross Alan Fialkov, D.C.

  • Chiropractor
  • Mountainside, NJ
National Provider Identifier
1285969030
Registry record updated Mar 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00780100 Issued in NJ
Practice address
213 Summit Rd Ste 2L
Mountainside, NJ 07092-2316
Phone
(908) 264-8116
Fax
(888) 908-8284
NPI assigned
Oct 13, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X012532 NY
Chiropractor 111N00000X 38MC00780100 NJ Primary

Addresses

Primary practice location

213 Summit Rd Ste 2L
Mountainside, NJ 07092-2316

Mailing address

149 Twin LN N
Wantagh, NY 11793-1943
Phone (516) 658-3362

Other identifiers 2

IdentifierTypeStateIssuer
38MC00780100OtherNJLICENSE REGISTRATION
X012532OtherNYLICENSE

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)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
38MC00780100NJMDChiropractor
X012532NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Hockessin Chiropractic Centre Chiropractor PastSince Aug 13, 2014 Accepting new patients
Palm Coast Chiropractic Center, Jta Inc Chiropractor PastSince Feb 17, 2017 Accepting new patients

Organizations & group practices 2

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": "1255392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711670400000",
    "number": "1285969030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "149 TWIN LN N",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "117931943",
            "telephone_number": "516-658-3362",
            "fax_number": "516-595-1685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 SUMMIT RD STE 2L",
            "city": "MOUNTAINSIDE",
            "state": "NJ",
            "postal_code": "070922316",
            "telephone_number": "908-264-8116",
            "fax_number": "888-908-8284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIALKOV",
        "first_name": "ROSS",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-10-13",
        "last_updated": "2024-03-29",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X012532",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00780100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE REGISTRATION",
            "identifier": "38MC00780100",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "X012532",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountainside, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2024; 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.