Individual provider Active NPI

Jay M Burstein

  • Occupational Health Chiropractor
  • Providence, RI
National Provider Identifier
1508954637
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Health ChiropractorTaxonomy code 111NX0100X
License
MD10882 Issued in RI
Practice address
21 Peace St
Providence, RI 02907-1510
Phone
(401) 456-3649
Fax
(401) 752-8116
NPI assigned
Oct 11, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Health Chiropractor 111NX0100X MD10882 RI Primary

Addresses

Primary practice location

21 Peace St
Providence, RI 02907-1510

Mailing address

200 High Service Ave
Marion Hall
North Providence, RI 02904-5113
Phone (401) 456-3646

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

LicenseStateTypeSpecialty
MD10882RIMDOccupational Health Chiropractor

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508954637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HIGH SERVICE AVE",
            "address_2": "MARION HALL",
            "city": "NORTH PROVIDENCE",
            "state": "RI",
            "postal_code": "029045113",
            "telephone_number": "401-456-3646",
            "fax_number": "401-752-8116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 PEACE ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029071510",
            "telephone_number": "401-456-3649",
            "fax_number": "401-752-8116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURSTEIN",
        "first_name": "JAY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NX0100X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Occupational Health",
            "state": "RI",
            "license": "MD10882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.