Active NPI
Samuel Prata, DPT
- Rehabilitation Chiropractor
- Newark, NJ
National Provider Identifier
1487217238
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Chiropractor
- License
- FEF417A
- Practice address
- 275 Chestnut St # 169
Newark, NJ 07105-1570 - Phone
- (973) 465-4410
- NPI assigned
- Apr 17, 2019
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Rehabilitation Chiropractor | 111NR0400X | FEF417A | NJ | Primary |
Addresses
Primary practice location
275 Chestnut St # 169
Newark, NJ 07105-1570
Mailing address
Manufacturers PL # 2
1
Newark, NJ 07105
Phone (973) 465-4410
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SAMUEL8 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| FEF417A | NJ | MD | Rehabilitation Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555459200000",
"number": "1487217238",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "MANUFACTURERS PL # 2",
"address_2": "1",
"city": "NEWARK",
"state": "NJ",
"postal_code": "07105",
"telephone_number": "973-465-4410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "275 CHESTNUT ST # 169",
"city": "NEWARK",
"state": "NJ",
"postal_code": "071051570",
"telephone_number": "973-465-4410"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRATA",
"first_name": "SAMUEL",
"name_prefix": "Mr.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-04-17",
"last_updated": "2019-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "111NR0400X",
"taxonomy_group": "",
"desc": "Chiropractor, Rehabilitation",
"state": "NJ",
"license": "FEF417A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "SAMUEL8",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Newark, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.