Individual provider Active NPI

Joseph E Pfeifer, D.C.

  • Sports Physician Chiropractor
  • Lake Grove, NY
National Provider Identifier
1619027455
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
X004179 Issued in NY
Practice address
881 Hawkins Ave
Lake Grove, NY 11755-1601
Phone
(631) 588-3388
Fax
(631) 588-5968
NPI assigned
Jan 12, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Chiropractor 111NN0400X X004179 NY
Sports Physician Chiropractor 111NS0005X X004179 NY Primary
Chiropractor 111N00000X X004179 NY

Addresses

Primary practice location

881 Hawkins Ave
Lake Grove, NY 11755-1601

Mailing address

881 Hawkins Ave
Lake Grove, NY 11755-1601
Phone (631) 588-3388

Other identifiers 6

IdentifierTypeStateIssuer
26904OtherNYGHI
1025707OtherNYAETNA
125619OtherNYACN
C04179-0OtherNYWORKERS' COMP
SF00000371OtherNYSELECT PRO
X8851OtherNYBLUE CHOICE

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
X004179NYMDSports Physician Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast College of Health Sciences Chiropractor Past Accepting new patients
New York Neurology and Medical Services P.C Neurology Past Accepting new patients
Lake Grove Chiropractic Chiropractor Past Accepting new patients

Organizations & group practices 3

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": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1619027455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "881 HAWKINS AVE",
            "city": "LAKE GROVE",
            "state": "NY",
            "postal_code": "117551601",
            "telephone_number": "631-588-3388",
            "fax_number": "631-588-5968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "881 HAWKINS AVE",
            "city": "LAKE GROVE",
            "state": "NY",
            "postal_code": "117551601",
            "telephone_number": "631-588-3388",
            "fax_number": "631-588-5968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PFEIFER",
        "first_name": "JOSEPH",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-12",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "NY",
            "license": "X004179",
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "NY",
            "license": "X004179",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X004179",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "26904",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "1025707",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACN",
            "identifier": "125619",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS' COMP",
            "identifier": "C04179-0",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SELECT PRO",
            "identifier": "SF00000371",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "X8851",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Grove, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.