Organization Active NPI

Brokstein Chiropractic LLC

  • Chiropractor
  • Freehold, NJ
National Provider Identifier
1417839432
Registry record updated Jul 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
BROKSTEIN CHIROPRACTIC LLC
Practice address
9 Broadway
Freehold, NJ 07728-1872
Phone
(732) 780-0044
Fax
(732) 780-3671
NPI assigned
Jul 22, 2025
Last updated
Jul 22, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2025

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

Authorized official

Name
Dr. Russell Brokstein, DCNPI 1841224995
Title
Sole Member
Phone
(732) 780-0044

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

9 Broadway
Freehold, NJ 07728-1872

Mailing address

9 Broadway
Freehold, NJ 07728-1872
Phone (732) 780-0044

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250925002673 NJ Part B Supplier - Clinic/Group Practice 0345745873 Receives reassigned benefits from 1 practitioner
Practice locations: Freehold, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1753142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753142400000",
    "number": "1417839432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 BROADWAY",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077281872",
            "telephone_number": "732-780-0044",
            "fax_number": "732-780-3671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 BROADWAY",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077281872",
            "telephone_number": "732-780-0044",
            "fax_number": "732-780-3671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROKSTEIN CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-22",
        "last_updated": "2025-07-22",
        "certification_date": "2025-07-22",
        "status": "A",
        "authorized_official_last_name": "BROKSTEIN",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "732-780-0044",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freehold, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.