Individual provider Active NPI

Peter Munda, CH

  • Orthopedic Chiropractor
  • Glen Cove, NY
National Provider Identifier
1467463588
Registry record updated Nov 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic ChiropractorTaxonomy code 111NX0800X
License
X0002739-1 Issued in NY
Practice address
70 Glen St
Suite 380
Glen Cove, NY 11542-2858
Phone
(516) 759-2424
Fax
(516) 759-6627
NPI assigned
Aug 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Chiropractor 111NX0800X X0002739-1 NY Primary

Addresses

Primary practice location

70 Glen St
Suite 380
Glen Cove, NY 11542-2858

Mailing address

70 Glen St
Suite 380
Glen Cove, NY 11542-2858
Phone (516) 759-2424

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061114000335 NY Practitioner - Chiropractic 9931107505 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

70 Glen St
Glen Cove, NY 11542-2858
Phone (516) 759-2424

70 Glen St
Suite 380
Glen Cove, NY 11542-2855

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X0002739-1NYMDOrthopedic Chiropractor
002739NYMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sea Cliff Chiropractic Office PC CurrentSince Jul 31, 2006 Accepting new patients

Locations

70 Glen St
Ste 380
Glen Cove, NY 11542
Phone (516) 277-1153

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": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194480000000",
    "number": "1467463588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 GLEN ST",
            "address_2": "SUITE 380",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115422858",
            "telephone_number": "516-759-2424",
            "fax_number": "516-759-6627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 GLEN ST",
            "address_2": "SUITE 380",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115422858",
            "telephone_number": "516-759-2424",
            "fax_number": "516-759-6627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNDA",
        "first_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "CH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2007-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "NY",
            "license": "X0002739-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Cove, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.