Individual provider Active NPI

Vincent A Justino, DC

  • Chiropractor
  • New Paltz, NY
National Provider Identifier
1437265196
Registry record updated May 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X008964 Issued in NY
Practice address
218 Main St
New Paltz, NY 12561
Phone
(845) 255-5733
Fax
(845) 255-5766
NPI assigned
Aug 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X008964 NY Primary

Addresses

Primary practice location

218 Main St
New Paltz, NY 12561

Mailing address

218 Main St
New Paltz, NY 12561-1311
Phone (845) 255-5733

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040416000910 NY Practitioner - Chiropractic 1850386186 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1 -3 Henry W Dubois Dr
Suite 3
New Paltz, NY 12561-1428
Phone (845) 255-5733

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
008964NYMDMental Health Counselor
X008964NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Vincent a Justino DC PC Chiropractor CurrentSince Sep 26, 2003 Accepting new patients

Locations

218 Main St
New Paltz, NY 12561
Phone (845) 255-1978

1-3 Henry W Dubois Dr
Ste 3
New Paltz, NY 12561
Phone (845) 255-5733

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": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210636800000",
    "number": "1437265196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 MAIN ST",
            "city": "NEW PALTZ",
            "state": "NY",
            "postal_code": "125611311",
            "telephone_number": "845-255-5733",
            "fax_number": "845-255-5766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 MAIN ST",
            "city": "NEW PALTZ",
            "state": "NY",
            "postal_code": "12561",
            "telephone_number": "845-255-5733",
            "fax_number": "845-255-5766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUSTINO",
        "first_name": "VINCENT",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2008-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X008964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Paltz, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2008; 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.