Individual provider Active NPI

Robert Tartaglia, D.S.

  • Chiropractor
  • Wayne, NJ
National Provider Identifier
1376561431
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00590400 Issued in NJ
Practice address
401 Hamburg Tpke
Wayne, NJ 07470-2154
Phone
(201) 264-2099
Fax
(201) 327-3597
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 38MC00590400 NJ Primary

Addresses

Primary practice location

401 Hamburg Tpke
Wayne, NJ 07470-2154

Mailing address

1 Elden Dr
Saddle River, NJ 07458-2809
Phone (201) 264-2099

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061206000011 NJ Practitioner - Chiropractic 3779582507 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1 Broadway
Suite 105
Elmwood Park, NJ 07407-1843
Phone (973) 529-3197

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38MC00590400NJMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Premier Medical Care LLC Past Accepting new patients
Revoredo Medical Affiliates LLC Past Accepting new patients
R & R Rehabilitation and Physical Therapy, LLC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FAJEDD

Organizations & group practices 4

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376561431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ELDEN DR",
            "city": "SADDLE RIVER",
            "state": "NJ",
            "postal_code": "074582809",
            "telephone_number": "201-264-2099",
            "fax_number": "201-327-3597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 HAMBURG TPKE",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702154",
            "telephone_number": "201-264-2099",
            "fax_number": "201-327-3597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARTAGLIA",
        "first_name": "ROBERT",
        "credential": "D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00590400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, NJ

Sources for this page

  • 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.
  • 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.