Active NPI
Chris Wildenauer, D.C.
- Chiropractor
- Seaford, NY
National Provider Identifier
1346341765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- X009813
- Practice address
- 2137 Jackson Ave
Seaford, NY 11783-2605 - Phone
- (516) 781-1018
- Fax
- (516) 679-2589
- NPI assigned
- Sep 26, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | X009813 | NY | Primary |
Addresses
Primary practice location
2137 Jackson Ave
Seaford, NY 11783-2605
Mailing address
2137 Jackson Ave
Seaford, NY 11783-2605
Phone (516) 781-1018
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00318049 | Other | NY | RAIL ROAD MEDICARE |
| P2115919 | Other | NY | OXFORD ID NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101026001014 | NY | Practitioner - Chiropractic | 1951594621 | Practice locations: Seaford, NY |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Sherman College of Straight Chiropractic, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2137 Jackson Ave
Seaford, NY 11783-2605
Phone (516) 781-1018
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| X009813 | NY | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1506384000000",
"number": "1346341765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2137 JACKSON AVE",
"city": "SEAFORD",
"state": "NY",
"postal_code": "117832605",
"telephone_number": "516-781-1018",
"fax_number": "516-679-2589"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2137 JACKSON AVE",
"city": "SEAFORD",
"state": "NY",
"postal_code": "117832605",
"telephone_number": "516-781-1018",
"fax_number": "516-679-2589"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILDENAUER",
"first_name": "CHRIS",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-26",
"last_updated": "2017-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NY",
"license": "X009813",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAIL ROAD MEDICARE",
"identifier": "P00318049",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD ID NUMBER",
"identifier": "P2115919",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Seaford, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2017; 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.