Individual provider Active NPI

Jennifer Elsholz, D.C.

  • Chiropractor
  • Coram, NY
National Provider Identifier
1396921276
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
011495 Issued in NY
Practice address
999 Old Town Rd
Coram, NY 11727-1853
Phone
(631) 331-5353
Fax
(631) 698-1379
NPI assigned
Jan 10, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 011495 NY Primary

Addresses

Primary practice location

999 Old Town Rd
Coram, NY 11727-1853

Mailing address

999 Old Town Rd
Coram, NY 11727-1853
Phone (631) 331-5353

Other names 1

  • Dr. Jennifer Beck Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080318000321 NY Practitioner - Chiropractic 8325124225 Practice locations: Miller Place, NY

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

85 Echo Ave
Suite 4
Miller Place, NY 11764-2200
Phone (631) 331-5353

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
011495NYMDLocal Education Agency (LEA)

Practice roles

OrganizationSpecialtyStatusNew patients
North Island Medical, P.C. Past Accepting new patients

Organizations & group practices 1

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": "1199923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1396921276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "999 OLD TOWN RD",
            "city": "CORAM",
            "state": "NY",
            "postal_code": "117271853",
            "telephone_number": "631-331-5353",
            "fax_number": "631-698-1379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 OLD TOWN RD",
            "city": "CORAM",
            "state": "NY",
            "postal_code": "117271853",
            "telephone_number": "631-331-5353",
            "fax_number": "631-698-1379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELSHOLZ",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-10",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "011495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "BECK",
            "prefix": "DR.",
            "credential": "D.C.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Coram, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2024; 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.