Individual provider Active NPI

Anthony Ambrogio, DC, ATC

  • Chiropractor
  • Matawan, NJ
National Provider Identifier
1407329378
Registry record updated Jan 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00758300 Issued in NJ
Practice address
144 Route 34
Matawan, NJ 07747-2132
Phone
(732) 320-6285
Fax
(732) 374-9864
NPI assigned
Jan 3, 2019
Last updated
Jan 3, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 38MC00758300 NJ Primary

Addresses

Primary practice location

144 Route 34
Matawan, NJ 07747-2132

Mailing address

144 Route 34
Matawan, NJ 07747-2132
Phone (732) 320-6285

Other identifiers 1

IdentifierTypeStateIssuer
38MC00758300OtherNJLICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190128002252 NJ Practitioner - Chiropractic 9830436922 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Old Bridge Spine and Wellness Center,PAGroup PAC ID 7416137492, 23 clinicians

Practice addresses (Care Compare)

144 Hwy 34
Matawan, NJ 07747-2132
Phone (732) 320-6285

144 TR
Suite 344
Matawan, NJ 07747-2132

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Old Bridge Spine & Wellness Center,PA CurrentSince Jan 3, 2019 Accepting new patients

Locations

144 State Route 34
Matawan, NJ 07747
Phone (732) 316-5895

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1546473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546473600000",
    "number": "1407329378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 ROUTE 34",
            "city": "MATAWAN",
            "state": "NJ",
            "postal_code": "077472132",
            "telephone_number": "732-320-6285",
            "fax_number": "732-374-9864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 ROUTE 34",
            "city": "MATAWAN",
            "state": "NJ",
            "postal_code": "077472132",
            "telephone_number": "732-320-6285",
            "fax_number": "732-374-9864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMBROGIO",
        "first_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "DC, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-03",
        "last_updated": "2019-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00758300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "38MC00758300",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Matawan, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2019; 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.