Active NPI
Jeffrey Nazar, D.C.
- Chiropractor
- Aquebogue, NY
National Provider Identifier
1447250261
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- X007763-1
- Practice address
- 487 Main Road
A & B
Aquebogue, NY 11931-0596 - Phone
- (631) 722-4425
- Fax
- (631) 722-4480
- NPI assigned
- Jul 22, 2005
- Reactivated
- Mar 28, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | X007763-1 | NY | Primary |
Addresses
Primary practice location
487 Main Road
A & B
Aquebogue, NY 11931-0596
Mailing address
PO Box 596
Aquebogue, NY 11931-0596
Phone (631) 722-4425
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040401000433 | NY | Practitioner - Chiropractic | 1052303864 | Practice locations: Riverhead, NY |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| X007763-1 | NY | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121990400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1292889600000",
"number": "1447250261",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 596",
"city": "AQUEBOGUE",
"state": "NY",
"postal_code": "119310596",
"telephone_number": "631-722-4425",
"fax_number": "631-722-4480"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "487 MAIN ROAD",
"address_2": "A & B",
"city": "AQUEBOGUE",
"state": "NY",
"postal_code": "119310596",
"telephone_number": "631-722-4425",
"fax_number": "631-722-4480"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NAZAR",
"first_name": "JEFFREY",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-07-22",
"last_updated": "2010-12-21",
"deactivation_date": "2006-03-21",
"reactivation_date": "2006-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NY",
"license": "X007763-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Aquebogue, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2010; 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.