Individual provider Active NPI

Paul G Rykaczewski, DC

  • Chiropractor
  • Voorhees, NJ
National Provider Identifier
1508887654
Registry record updated Mar 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00469100 Issued in NJ
Practice address
2 Sheppard Rd
Suite 102
Voorhees, NJ 08043-4787
Phone
(856) 874-0080
Fax
(856) 874-0085
NPI assigned
Jul 22, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 38MC00469100 NJ Primary
Chiropractor 111N00000X DC006211L PA

Addresses

Primary practice location

2 Sheppard Rd
Suite 102
Voorhees, NJ 08043-4787

Mailing address

2 Sheppard Rd
Suite 102
Voorhees, NJ 08043-4787
Phone (856) 874-0080

Other identifiers 1

IdentifierTypeStateIssuer
7448309MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090814000559 NJ Practitioner - Chiropractic 3072667708 Practice locations: Voorhees, NJ

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2 Sheppard Rd
Suite 102
Voorhees, NJ 08043-4787
Phone (856) 874-0080

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC006211LPAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267574400000",
    "number": "1508887654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 SHEPPARD RD",
            "address_2": "SUITE 102",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080434787",
            "telephone_number": "856-874-0080",
            "fax_number": "856-874-0085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 SHEPPARD RD",
            "address_2": "SUITE 102",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080434787",
            "telephone_number": "856-874-0080",
            "fax_number": "856-874-0085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYKACZEWSKI",
        "first_name": "PAUL",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-22",
        "last_updated": "2010-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00469100",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC006211L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7448309",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Voorhees, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2010; 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.