Individual provider Active NPI

Kimberly A. Siegel, D.C., D.I.C.C.P.

  • Chiropractor
  • Perth Amboy, NJ
National Provider Identifier
1457550055
Registry record updated Jul 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
MC005240 Issued in NJ
Practice address
335 Maple St
Perth Amboy, NJ 08861-4109
Phone
(732) 376-0606
Fax
(732) 376-1614
NPI assigned
Jul 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X MC005240 NJ Primary

Addresses

Primary practice location

335 Maple St
Perth Amboy, NJ 08861-4109

Mailing address

PO Box 2558
Perth Amboy, NJ 08862-2558
Phone (732) 376-0606

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040708000235 NJ Practitioner - Chiropractic 5890773873 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elite Chiropractic and Wellness CenterGroup PAC ID 0446218838, 4 clinicians

Practice addresses (Care Compare)

1275 Route 35
Suite 6
Middletown, NJ 07748-2000
Phone (732) 739-3345

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MC005240NJMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Chiropractic & Wellness Center Chiropractor CurrentSince Oct 14, 2023 Accepting new patients

Locations

1275 State Route 35
Ste 6
Middletown, NJ 07748
Phone (732) 739-3345

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": "1184284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184284800000",
    "number": "1457550055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2558",
            "city": "PERTH AMBOY",
            "state": "NJ",
            "postal_code": "088622558",
            "telephone_number": "732-376-0606",
            "fax_number": "732-376-1614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 MAPLE ST",
            "city": "PERTH AMBOY",
            "state": "NJ",
            "postal_code": "088614109",
            "telephone_number": "732-376-0606",
            "fax_number": "732-376-1614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEGEL",
        "first_name": "KIMBERLY",
        "middle_name": "A.",
        "name_prefix": "Mrs.",
        "credential": "D.C., D.I.C.C.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-13",
        "last_updated": "2007-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "MC005240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Perth Amboy, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2007; 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.