Samuel P Selimo, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

MC02363 Issued in NJ

Practice address

125 Madison St
Boonton, NJ 07005-2153

Phone

(973) 299-2430

Fax

(973) 299-2433

NPI assigned

Jan 4, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Promed Preferred NJ 2 PC

  dba Health Atlast Boonton

  • Internal Medicine Physician
  • Boonton, NJ
  • NPI 1942075346
  NPD (past)
• Synergy Chiropractic Center LLC

  • Clinic/Center
  • Boonton, NJ
  • NPI 1295249613
  NPD (past)

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336296375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 MADISON ST",
            "city": "BOONTON",
            "state": "NJ",
            "postal_code": "070052153",
            "telephone_number": "973-299-2430",
            "fax_number": "973-299-2433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 MADISON ST",
            "city": "BOONTON",
            "state": "NJ",
            "postal_code": "070052153",
            "telephone_number": "973-299-2430",
            "fax_number": "973-299-2433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELIMO",
        "first_name": "SAMUEL",
        "middle_name": "P",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "MC02363",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3151240",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Joseph Santoro, MA, LCADC
• Philip Mark Scaduto, MD
• Stephanie Sclafani
• Brenda Joyce Scott, MSW
• Patrick M Selimo, DC
• Anisha Sharma
• Pankil Rajendra Sheth, DOCTOR OF PHARMACY
• Maggie Shin
• Randolph Scott Shipon, PH.D., NCC, LPC
• Rushank Shukla, RPH

• Chiropractor in Boonton, NJ
• Providers in Boonton, NJ by specialty
• Chiropractor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.