Michael Fenster, D.C.
Individual provider Active NPI Chiropractor · Avondale Estates, GA
NPI 1407248362 · NPPES record last updated Jan 30, 2024
Key facts
- NPI
- 1407248362
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 010390 (GA)
- Practice address
- 8 N Clarendon Ave Ste 300
Avondale Estates, GA 30002-1150 - Phone
- (404) 242-2164
- NPI assigned
- Mar 2, 2015
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Other, 2014
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
551 Madison Ave
Suite 1201
New York, NY 10022-3212
8 N Clarendon Ave
Suite 300
Avondale Estates, GA 30002-1150
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260303002810 | NY | Practitioner - Chiropractic | 0042792780 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 70 012583 | NY | MD | Chiropractor |
| 010390 | GA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Complete Wellness Medical PC | Chiropractor | Current |
Accepting new patients |
Locations
551 Madison Ave
Ste 1201
New York, NY 10022
Phone (212) 737-0000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 70 012583 | NY | |
| Chiropractor | 111N00000X | 010390 | GA | Yes |
Addresses
Primary practice location
8 N Clarendon Ave Ste 300
Avondale Estates, GA 30002-1150
Mailing address
8 N Clarendon Ave Ste 300
Avondale Estates, GA 30002-1150
Phone (404) 242-2164
Other providers in Avondale Estates, GA
- Vivian Daniel
- Lucretia Smith Dubose
- Julie K Ellers
- Evelyn Nicole Ellington
- Euim American Tech Systems Inc.
- Firefly Wellness Counseling, LLC
- Joann Marie Cordero Fleckenstein
- Christine Frederick
- Sarah Slocum Freeman
- Good Grief Counseling & Consulting LLC
All providers in Avondale Estates, GA · Chiropractor in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 30, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.