Individual provider Active NPI

Ian Raphael Barry, DC

  • Chiropractor
  • Short Hills, NJ
National Provider Identifier
1417412966
Registry record updated Feb 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00759500 Issued in NJ
Practice address
532 Old Short Hills Rd
Short Hills, NJ 07078-1437
Phone
(973) 467-9011
NPI assigned
Feb 8, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 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 38MC00759500 NJ Primary

Addresses

Primary practice location

532 Old Short Hills Rd
Short Hills, NJ 07078-1437

Mailing address

532 Old Short Hills Rd
Short Hills, NJ 07078-1437
Phone (973) 985-6637

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190313002517 NJ Practitioner - Chiropractic 1759621543 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

145 Commons Way
Bridgewater, NJ 08807-2801
Phone (908) 800-5158

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38MC00759500NJMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Performance and Rehabilitation Center, LLC Chiropractor CurrentSince Feb 21, 2019 Accepting new patients
Life Clinic of NJ DC PA Chiropractor CurrentSince Sep 10, 2022 Accepting new patients

Locations

145 Commons Way
Bridgewater, NJ 08807
Phone (908) 800-5158

Organizations & group practices 2

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": "1549584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549584000000",
    "number": "1417412966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "532 OLD SHORT HILLS RD",
            "city": "SHORT HILLS",
            "state": "NJ",
            "postal_code": "070781437",
            "telephone_number": "973-985-6637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "532 OLD SHORT HILLS RD",
            "city": "SHORT HILLS",
            "state": "NJ",
            "postal_code": "070781437",
            "telephone_number": "973-467-9011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARRY",
        "first_name": "IAN",
        "middle_name": "RAPHAEL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-02-08",
        "last_updated": "2019-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00759500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Short Hills, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 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.