Individual provider Active NPI

Joseph G Zdyrski, D.C.

  • Chiropractor
  • Belleville, NJ
National Provider Identifier
1326125493
Registry record updated Sep 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00299300 Issued in NJ
Practice address
441 Franklin Avenue
Belleville, NJ 07109
Phone
(973) 759-1702
Fax
(973) 759-2399
NPI assigned
Nov 1, 2006
Last updated
Sep 28, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 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 X004260-1 NY
Chiropractor 111N00000X 38MC00299300 NJ Primary

Addresses

Primary practice location

441 Franklin Avenue
Belleville, NJ 07109

Mailing address

441 Franklin Avenue
Belleville, NJ 07109
Phone (973) 759-1702

Other identifiers 1

IdentifierTypeStateIssuer
2104300-01MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111116000268 NJ Practitioner - Chiropractic 1850565417 Practice locations: Belleville, NJ

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

441 Franklin Ave
Belleville, NJ 07109-1544
Phone (973) 759-1702

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38MC00299300NJMDChiropractor
X004260-1NYMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190937600000",
    "number": "1326125493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "441 FRANKLIN AVENUE",
            "city": "BELLEVILLE",
            "state": "NJ",
            "postal_code": "07109",
            "telephone_number": "973-759-1702",
            "fax_number": "973-759-2399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "441 FRANKLIN AVENUE",
            "city": "BELLEVILLE",
            "state": "NJ",
            "postal_code": "07109",
            "telephone_number": "973-759-1702",
            "fax_number": "973-759-2399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZDYRSKI",
        "first_name": "JOSEPH",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X004260-1",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00299300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2104300-01",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleville, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 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.