Individual provider Active NPI

Philip C Grivas, DC

  • Chiropractor
  • Red Bank, NJ
National Provider Identifier
1417973702
Registry record updated Feb 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00577300 Issued in NJ
Practice address
258 NJ 35 South
Red Bank, NJ 07701
Phone
(732) 593-9962
NPI assigned
Jul 14, 2006
Last updated
Feb 23, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 38MC00577300 NJ Primary

Addresses

Primary practice location

258 NJ 35 South
Red Bank, NJ 07701

Mailing address

258 NJ 35 South
Red Bank, NJ 07701
Phone (732) 593-9962

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040519000513 NJ Practitioner - Chiropractic 6406847565 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

258 NJ 35
Red Bank, NJ 07701
Phone (732) 593-9962

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38MC00577300NJMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Motion Chiropractic Group PC Chiropractor CurrentSince Jul 2, 2004 Accepting new patients

Locations

1126 State Route 35
Middletown, NJ 07748
Phone (732) 593-9962

2345 Route 66
Ocean, NJ 07712
Phone (732) 493-0110

258 State Route 35
Red Bank, NJ 07701
Phone (732) 221-4074

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": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708646400000",
    "number": "1417973702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "258 NJ 35 SOUTH",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "07701",
            "telephone_number": "732-593-9962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "258 NJ 35 SOUTH",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "07701",
            "telephone_number": "732-593-9962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIVAS",
        "first_name": "PHILIP",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2024-02-23",
        "certification_date": "2024-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00577300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Red Bank, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2024; 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.