Individual provider Active NPI

Glenn Anthony Grieco, DC

  • Chiropractor
  • Oakhurst, NJ
National Provider Identifier
1578609608
Registry record updated Apr 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00555800 Issued in NJ
Practice address
257 Monmouth Rd Ste 5
Oakhurst, NJ 07755-1501
Phone
(732) 517-1090
Fax
(732) 517-1096
NPI assigned
Jan 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 38MC00555800 NJ Primary

Addresses

Primary practice location

257 Monmouth Rd Ste 5
Oakhurst, NJ 07755-1501

Mailing address

257 Monmouth Rd Ste 5
Oakhurst, NJ 07755-1501
Phone (732) 517-1090

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120427000216 NJ Practitioner - Chiropractic 5698936771 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Park Chiropractic CenterGroup PAC ID 3072774157, 2 clinicians

Practice addresses (Care Compare)

257 Monmouth Rd
Suite 5
Oakhurst, NJ 07755-1501
Phone (732) 517-1090

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
West Park Chiropractic Center Chiropractor CurrentSince Apr 1, 2001 Accepting new patients

Locations

780 W Park Ave
Oakhurst, NJ 07755
Phone (732) 517-1090

257 Monmouth Rd
Ste 5
Oakhurst, NJ 07755
Phone (732) 517-1090

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681689600000",
    "number": "1578609608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "257 MONMOUTH RD STE 5",
            "city": "OAKHURST",
            "state": "NJ",
            "postal_code": "077551501",
            "telephone_number": "732-517-1090",
            "fax_number": "732-517-1096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "257 MONMOUTH RD STE 5",
            "city": "OAKHURST",
            "state": "NJ",
            "postal_code": "077551501",
            "telephone_number": "732-517-1090",
            "fax_number": "732-517-1096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIECO",
        "first_name": "GLENN",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2023-04-17",
        "certification_date": "2023-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00555800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakhurst, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2023; 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.