Lawrence Petracco, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

38MC00495100 Issued in NJ

Practice address

218 Newark Ave
Jersey City, NJ 07302-2736

Phone

(201) 533-0055

Fax

(201) 533-0066

NPI assigned

Jul 6, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College - West, 1996

Medicare assignment

May accept Medicare assignment

Group practices

Center for Joint and Spine ReliefGroup PAC ID 3870755960, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lawrence.petracco@tjasc-nj.direct.office.nextgen.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Center for Joint and Spine Relief

  • Interventional Pain Medicine Physician
  • Jersey City, NJ
  • NPI 1205121316

  NJ

  Medicare reassignment Care Compare group NPD
• Ther Center for Joint & Spine Relief

  • Chiropractor
  • Jersey City, NJ
  • NPI 1124424031
  NPD (past)

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528090149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 NEWARK AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073022736",
            "telephone_number": "201-533-0055",
            "fax_number": "201-533-0066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 NEWARK AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073022736",
            "telephone_number": "201-533-0055",
            "fax_number": "201-533-0066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRACCO",
        "first_name": "LAWRENCE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00495100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pershing Dialysis LLC
• Peter Wong MD
• Shanice Peters, MD
• Yvette Petion
• Petracco Chiropractic Center P a
• Robin Lynn Petrick, IBCLC
• Janna Petrovitch, PHARMD
• Katherine Pettick-Perez, LMHC
• Pha4 LLC
• Pha4 LLC

• Chiropractor in Jersey City, NJ
• Providers in Jersey City, NJ by specialty
• Chiropractor in New Jersey

• 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.
• 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.