Individual provider Active NPI

Adam Edward Chudzikiewicz, DC

  • Chiropractor
  • Marlborough, MA
National Provider Identifier
1407538614
Registry record updated Aug 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHI3833 Issued in MA
Practice address
340 Maple St Ste 101
Marlborough, MA 01752-3200
Phone
(508) 481-1133
Fax
(508) 229-0609
NPI assigned
Aug 7, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHI3833 MA Primary

Addresses

Primary practice location

340 Maple St Ste 101
Marlborough, MA 01752-3200

Mailing address

340 Maple St Ste 101
Marlborough, MA 01752-3200
Phone (508) 481-1133

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHI3833MAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Marlborough Chiropractic Inc Chiropractor CurrentSince Aug 27, 2023 Accepting new patients

Locations

340 Maple St
Ste 101
Marlborough, MA 01752
Phone (508) 481-1133

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": "1691366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1407538614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 MAPLE ST STE 101",
            "city": "MARLBOROUGH",
            "state": "MA",
            "postal_code": "017523200",
            "telephone_number": "508-481-1133",
            "fax_number": "508-229-0609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 MAPLE ST STE 101",
            "city": "MARLBOROUGH",
            "state": "MA",
            "postal_code": "017523200",
            "telephone_number": "508-481-1133",
            "fax_number": "508-229-0609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUDZIKIEWICZ",
        "first_name": "ADAM",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-08-07",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "CHI3833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlborough, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.