Organization Active NPI

Rebisz Chiropractic LLC

  • Rehabilitation Chiropractor
  • Garfield, NJ
National Provider Identifier
1437422607
Registry record updated Feb 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
38MC00357600 Issued in NJ
Legal business name
REBISZ CHIROPRACTIC LLC
Practice address
430 Midland Ave.
Garfield, NJ 07026
Phone
(973) 772-0411
Fax
(973) 772-4934
NPI assigned
Feb 17, 2012
Organization subpart
Yes
Parent organization
REBISZ CHIROPRACTIC LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 17, 2012

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

Authorized official

Name
Dr. Kathleen S. Rebisz, DC, PACRB
Title
Owner
Phone
(973) 772-0411

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NR0400X 38MC00357600 NJ Primary

Addresses

Primary practice location

430 Midland Ave.
Garfield, NJ 07026

Mailing address

430 Midland Ave.
Garfield, NJ 07026
Phone (973) 772-0411

Other identifiers 1

IdentifierTypeStateIssuer
8480508MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190327000355 NJ Part B Supplier - Clinic/Group Practice 5294075305 Receives reassigned benefits from 1 practitioner
Practice locations: Garfield, NJ

National Provider Directory

National Provider Directory
Part of
Rebisz Chiropractic LLC

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1329436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329436800000",
    "number": "1437422607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 MIDLAND AVE.",
            "city": "GARFIELD",
            "state": "NJ",
            "postal_code": "07026",
            "telephone_number": "973-772-0411",
            "fax_number": "973-772-4934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 MIDLAND AVE.",
            "city": "GARFIELD",
            "state": "NJ",
            "postal_code": "07026",
            "telephone_number": "973-772-0411",
            "fax_number": "973-772-4934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REBISZ CHIROPRACTIC LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "REBISZ CHIROPRACTIC LLC",
        "enumeration_date": "2012-02-17",
        "last_updated": "2012-02-17",
        "status": "A",
        "authorized_official_last_name": "REBISZ",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-772-0411",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC, PACRB"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "NJ",
            "license": "38MC00357600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8480508",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garfield, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2012; 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.