Individual provider Active NPI

David Scott Fuggetta, D.C.

  • Chiropractor
  • Howard Beach, NY
National Provider Identifier
1629155627
Registry record updated Sep 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X009366-1 Issued in NY
Practice address
9117 157TH Ave
Howard Beach, NY 11414-2741
Phone
(718) 845-6600
Fax
(718) 738-1782
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 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 X009366-1 NY Primary

Addresses

Primary practice location

9117 157TH Ave
Howard Beach, NY 11414-2741

Mailing address

9117 157TH Ave
Howard Beach, NY 11414-2741
Phone (718) 845-6600

Other identifiers 4

IdentifierTypeStateIssuer
5806185OtherNYGHI
617429OtherNYUNITED HEALTHCARE
P2162430OtherNYOXFORD HEALTHCARE
X0G810OtherNYBLUECROSS/BLUESHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090330000119 NY Practitioner - Chiropractic 3375616394 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

91 -17
Howard Beach, NY 11414-2741

9117 157TH Ave
Howard Beach, NY 11414-2741
Phone (718) 845-6600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X009366-1NYMDChiropractor
009366NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Rockwood Park Chiropractic, P.C. Chiropractor CurrentSince Nov 1, 2000 Accepting new patients

Locations

9117 157th Ave
Jamaica, NY 11414
Phone (718) 564-4031

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316736000000",
    "number": "1629155627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9117 157TH AVE",
            "city": "HOWARD BEACH",
            "state": "NY",
            "postal_code": "114142741",
            "telephone_number": "718-845-6600",
            "fax_number": "718-738-1782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9117 157TH AVE",
            "city": "HOWARD BEACH",
            "state": "NY",
            "postal_code": "114142741",
            "telephone_number": "718-845-6600",
            "fax_number": "718-738-1782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUGGETTA",
        "first_name": "DAVID",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2011-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X009366-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "5806185",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "617429",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD HEALTHCARE",
            "identifier": "P2162430",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS/BLUESHIELD",
            "identifier": "X0G810",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Howard Beach, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 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.