NPIMap

Organization Active NPI

East Greenbush Chiropractic PLLC

  • Chiropractor
  • East Greenbush, NY
National Provider Identifier
1639645419
Registry record updated Oct 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
EAST GREENBUSH CHIROPRACTIC PLLC
Practice address
569 Columbia Turnpike
East Greenbush, NY 12061
Phone
(518) 477-5000
Fax
(518) 477-5009
NPI assigned
Oct 18, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2018

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

Authorized official

Name
Lee Irish
Title
Billing Manager
Phone
(518) 477-5000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

569 Columbia Turnpike
East Greenbush, NY 12061

Mailing address

569 Columbia Tpke
East Greenbush, NY 12061-1621
Phone (518) 477-5000

Other names 1

  • East Greenbush Chiropractic Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181024001327 NY Part B Supplier - Clinic/Group Practice 8820341605 Receives reassigned benefits from 1 practitioner
Practice locations: East Greenbush, NY

National Provider Directory

National Provider Directory
Tax ID family
East Greenbush Chiropractic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

569 Columbia Tpke
East Greenbush, NY 12061
Phone (518) 477-5000

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1539820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539820800000",
    "number": "1639645419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "569 COLUMBIA TPKE",
            "city": "EAST GREENBUSH",
            "state": "NY",
            "postal_code": "120611621",
            "telephone_number": "518-477-5000",
            "fax_number": "518-477-5009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "569 COLUMBIA TURNPIKE",
            "city": "EAST GREENBUSH",
            "state": "NY",
            "postal_code": "12061",
            "telephone_number": "518-477-5000",
            "fax_number": "518-477-5009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST GREENBUSH CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-18",
        "last_updated": "2018-10-18",
        "status": "A",
        "authorized_official_last_name": "IRISH",
        "authorized_official_first_name": "LEE",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "518-477-5000"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Greenbush Chiropractic",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in East Greenbush, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.