Organization Active NPI

Rockaway Family Chiropractic PC

  • Chiropractor
  • Belle Harbor, NY
National Provider Identifier
1376729160
Registry record updated Sep 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X008394-1 Issued in NY
Legal business name
ROCKAWAY FAMILY CHIROPRACTIC PC
Practice address
12910 Newport Ave
Belle Harbor, NY 11694-1617
Phone
(718) 634-4800
Fax
(718) 474-0735
NPI assigned
Jan 11, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2012

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

Authorized official

Name
Terrence MundyNPI 1992835672
Title
Owner
Phone
(718) 634-4800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X X008394-1 NY Primary

Addresses

Primary practice location

12910 Newport Ave
Belle Harbor, NY 11694-1617

Mailing address

12910 Newport Ave
Belle Harbor, NY 11694-1617
Phone (718) 634-4800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120926000609 NY Part B Supplier - Clinic/Group Practice 0648429126 Receives reassigned benefits from 1 practitioner
Practice locations: Belle Harbor, NY

National Provider Directory

National Provider Directory

Locations

12910 Newport Ave
Rockaway Park, NY 11694
Phone (718) 634-4800

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1200009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348704000000",
    "number": "1376729160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12910 NEWPORT AVE",
            "city": "BELLE HARBOR",
            "state": "NY",
            "postal_code": "116941617",
            "telephone_number": "718-634-4800",
            "fax_number": "718-474-0735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12910 NEWPORT AVE",
            "city": "BELLE HARBOR",
            "state": "NY",
            "postal_code": "116941617",
            "telephone_number": "718-634-4800",
            "fax_number": "718-474-0735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKAWAY FAMILY CHIROPRACTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-11",
        "last_updated": "2012-09-27",
        "status": "A",
        "authorized_official_last_name": "MUNDY",
        "authorized_official_first_name": "TERRENCE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-634-4800"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X008394-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belle Harbor, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.