Organization Active NPI

Rockwood Park Chiropractic, P.C.

  • Chiropractor
  • Howard Beach, NY
National Provider Identifier
1467539478
Registry record updated May 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X009366-1 Issued in NY
Legal business name
ROCKWOOD PARK CHIROPRACTIC, P.C.
Practice address
9117 157TH Ave
Howard Beach, NY 11414-2741
Phone
(718) 845-6600
Fax
(718) 738-1782
NPI assigned
Nov 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2011

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

Authorized official

Name
Dr. David Scott Fuggetta, D.C.NPI 1629155627
Title
President
Phone
(718) 845-6600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X X009366-1 NY Primary

Addresses

Primary practice location

9117 157TH Ave
Howard Beach, NY 11414-2741

Mailing address

9117 157TH Ave
Howard Beach, NY 11414-2741
Phone (718) 845-6600

Other identifiers 4

IdentifierTypeStateIssuer
617429OtherNYUNITED HEALTHCARE
5898353OtherNYGHI
X0G810OtherNYBLUECROSS/BLUESHIELD
P2162430OtherNYOXFORD HEALTHCARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090330000142 NY Part B Supplier - Clinic/Group Practice 9335212497 Receives reassigned benefits from 1 practitioner
Practice locations: Howard Beach, NY

National Provider Directory

National Provider Directory

Locations

9117 157th Ave
Jamaica, NY 11414
Phone (718) 564-4031

Practitioners & affiliated clinicians

Practitioners 2

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": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305158400000",
    "number": "1467539478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9117 157TH AVE",
            "city": "HOWARD BEACH",
            "state": "NY",
            "postal_code": "114142741",
            "telephone_number": "718-845-6600",
            "fax_number": "718-738-1782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9117 157TH AVE",
            "city": "HOWARD BEACH",
            "state": "NY",
            "postal_code": "114142741",
            "telephone_number": "718-845-6600",
            "fax_number": "718-738-1782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKWOOD PARK CHIROPRACTIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2011-05-12",
        "status": "A",
        "authorized_official_last_name": "FUGGETTA",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-845-6600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X009366-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "617429",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "5898353",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS/BLUESHIELD",
            "identifier": "X0G810",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD HEALTHCARE",
            "identifier": "P2162430",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Howard Beach, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2011; 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.