Organization Active NPI

Dr. a Richard Polino DCPC

  • Chiropractor
  • Delran, NJ
National Provider Identifier
1649480401
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
NJMC003340 Issued in NJ
Legal business name
DR. A RICHARD POLINO DCPC
Practice address
3001 Bridgeboro Rd
Delran, NJ 08075-9700
Phone
(856) 461-6262
Fax
(856) 461-7798
NPI assigned
May 23, 2007
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Mrs. Jennifer K Polino
Title
Office Manager
Phone
(856) 461-6262

Practitioners 3

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

Medicare participation

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

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20121102000156 NJ Part B Supplier - Clinic/Group Practice 2466602255 Receives reassigned benefits from 3 practitioners
Practice locations: Delran, NJ

National Provider Directory

National Provider Directory

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X NJMC003340 NJ Primary

Addresses

NPPES NPI Registry

Primary practice location

3001 Bridgeboro Rd
Delran, NJ 08075-9700

Mailing address

3001 Bridgeboro Rd
Delran, NJ 08075-9700
Phone (856) 461-6262

Other identifiers 3

NPPES NPI Registry
IdentifierTypeStateIssuer
8463905MedicaidNJ
8464006MedicaidNJ
1291700MedicaidNJ

Other names 1

NPPES NPI Registry
  • Delran Chiropractic PA Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 22, 2020.

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1649480401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 BRIDGEBORO RD",
            "city": "DELRAN",
            "state": "NJ",
            "postal_code": "080759700",
            "telephone_number": "856-461-6262",
            "fax_number": "856-461-7798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 BRIDGEBORO RD",
            "city": "DELRAN",
            "state": "NJ",
            "postal_code": "080759700",
            "telephone_number": "856-461-6262",
            "fax_number": "856-461-7798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. A RICHARD POLINO DCPC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "POLINO",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "856-461-6262",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "NJMC003340",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8463905",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8464006",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1291700",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Delran Chiropractic PA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Delran, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.