Individual provider Active NPI

Ellery Panaia III, DC

  • Chiropractor
  • Cherry Hill, NJ
National Provider Identifier
1629108972
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00430300 Issued in NJ
Practice address
1299 Brace Road
Cherry Hill, NJ 08034
Phone
(856) 795-2424
Fax
(856) 795-2212
NPI assigned
Mar 6, 2007
Sex
Male
Sole proprietor
No

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
Chiropractor 111N00000X 38MC00430300 NJ Primary

Addresses

Primary practice location

1299 Brace Road
Cherry Hill, NJ 08034

Mailing address

1299 Brace Road
Cherry Hill, NJ 08034
Phone (856) 795-2424

Other identifiers 2

IdentifierTypeStateIssuer
2707432000OtherNJBCBS AMERI HEALTH
0461651OtherNJAETNA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060314000129 NJ Practitioner - Chiropractic 7416964622 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1299 Brace Rd
Cherry Hill, NJ 08034-3214
Phone (856) 795-2424

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38MC00430300NJMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Panaia Chiropractic & Rehabilitation of Cherry Hill LLC Chiropractor CurrentSince Mar 27, 2009 Accepting new patients
Panaia Chiropractic of Cherry Hill Chiropractor Past Accepting new patients

Locations

1299 Brace Rd
Cherry Hill, NJ 08034
Phone (856) 429-8324

Organizations & group practices 2

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": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629108972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1299 BRACE ROAD",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "08034",
            "telephone_number": "856-795-2424",
            "fax_number": "856-795-2212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1299 BRACE ROAD",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "08034",
            "telephone_number": "856-795-2424",
            "fax_number": "856-795-2212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANAIA",
        "first_name": "ELLERY",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00430300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS AMERI HEALTH",
            "identifier": "2707432000",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0461651",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherry Hill, NJ

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.
  • 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.