Individual provider Active NPI

Brian Francis Civinski, DC

  • Chiropractor
  • Hamilton, NJ
National Provider Identifier
1609950864
Registry record updated Oct 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
MC00516500 Issued in NJ
Practice address
3105 Nottingham Way
Hamilton, NJ 08619-1844
Phone
(609) 631-7200
Fax
(609) 631-9363
NPI assigned
Oct 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X MC00516500 NJ Primary

Addresses

Primary practice location

3105 Nottingham Way
Hamilton, NJ 08619-1844

Mailing address

3105 Nottingham Way
Hamilton, NJ 08619-1844
Phone (609) 631-7200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111212000146 NJ Practitioner - Chiropractic 2860667300 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1997
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3105 Nottingham Way
Hamilton, NJ 08619-1844
Phone (609) 631-7200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MC00516500NJMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Mercer Family Chiropractic Chiropractor CurrentSince Oct 12, 2011 Accepting new patients

Locations

3105 Nottingham Way
Trenton, NJ 08619
Phone (609) 516-2982

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": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319846400000",
    "number": "1609950864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3105 NOTTINGHAM WAY",
            "city": "HAMILTON",
            "state": "NJ",
            "postal_code": "086191844",
            "telephone_number": "609-631-7200",
            "fax_number": "609-631-9363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3105 NOTTINGHAM WAY",
            "city": "HAMILTON",
            "state": "NJ",
            "postal_code": "086191844",
            "telephone_number": "609-631-7200",
            "fax_number": "609-631-9363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIVINSKI",
        "first_name": "BRIAN",
        "middle_name": "FRANCIS",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2011-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "MC00516500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamilton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2011; 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.