NPIMap

Organization Active NPI

Old Bridge Spine & Wellness Center,PA

  • Rehabilitation Chiropractor
  • Matawan, NJ
National Provider Identifier
1487885141
Registry record updated Feb 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
Legal business name
OLD BRIDGE SPINE & WELLNESS CENTER,PA
Practice address
144 Route 34
Matawan, NJ 07747-2132
Phone
(732) 316-5895
Fax
(732) 316-5894
NPI assigned
Jul 29, 2009
Last updated
Feb 10, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2020

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

Authorized official

Name
Dr. Arlene Kazio, DCNPI 1629127238
Title
VP
Phone
(732) 316-5895

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 12

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X
Primary Care Nurse Practitioner 363LP2300X
Acupuncturist 171100000X
Pain Medicine (Anesthesiology) Physician 207LP2900X
Family Medicine Physician 207Q00000X
Orthopaedic Surgery Physician 207X00000X
Orthopaedic Surgery of the Spine Physician 207XS0117X
Physical Medicine & Rehabilitation Physician 208100000X
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X
Foot & Ankle Surgery Podiatrist 213ES0103X
Physical Therapist 225100000X
Rehabilitation Chiropractor 111NR0400X Primary

Addresses

Primary practice location

144 Route 34
Matawan, NJ 07747-2132

Mailing address

144 Route 34
Matawan, NJ 07747-2132
Phone (732) 316-5895

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110208000743 NJ Part B Supplier - Clinic/Group Practice 7416137492 Receives reassigned benefits from 71 practitioners
Practice locations: Freehold, NJ; Matawan, NJ; Old Bridge, NJ

National Provider Directory

National Provider Directory

Locations

400 Perrine Rd
Ste 412
Old Bridge, NJ 08857
Phone (732) 320-6285

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 71

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 71

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1248825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581292800000",
    "number": "1487885141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 ROUTE 34",
            "city": "MATAWAN",
            "state": "NJ",
            "postal_code": "077472132",
            "telephone_number": "732-316-5895",
            "fax_number": "732-316-5894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 ROUTE 34",
            "city": "MATAWAN",
            "state": "NJ",
            "postal_code": "077472132",
            "telephone_number": "732-316-5895",
            "fax_number": "732-316-5894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLD BRIDGE SPINE & WELLNESS CENTER,PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-29",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A",
        "authorized_official_last_name": "KAZIO",
        "authorized_official_first_name": "ARLENE",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "732-316-5895",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Matawan, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2020; 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.