Individual provider Active NPI

William J Malta, D.C.

  • Chiropractor
  • Millburn, NJ
National Provider Identifier
1659373785
Registry record updated Nov 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00325100 Issued in NJ
Practice address
127 Millburn Ave
Millburn, NJ 07041-1917
Phone
(973) 379-7022
Fax
(973) 379-7023
NPI assigned
Aug 10, 2005
Last updated
Nov 26, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 26, 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 38MC00325100 NJ Primary

Addresses

Primary practice location

127 Millburn Ave
Millburn, NJ 07041-1917

Mailing address

127 Millburn Ave
Millburn, NJ 07041-1917
Phone (973) 379-7022

Other identifiers 1

IdentifierTypeStateIssuer
P484089OtherNJOXFORD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070726000105 NJ Practitioner - Chiropractic 4587765136 Practice locations: Springfield, NJ

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1986
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

26 Linden Ave
Suite 102
Springfield, NJ 07081-1800
Phone (973) 379-7022

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38MC00325100NJMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Pase Healthcare, PC PastSince Aug 11, 2006 Accepting new patients
NJ Gastro, LLC Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322265600000",
    "number": "1659373785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 MILLBURN AVE",
            "city": "MILLBURN",
            "state": "NJ",
            "postal_code": "070411917",
            "telephone_number": "973-379-7022",
            "fax_number": "973-379-7023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 MILLBURN AVE",
            "city": "MILLBURN",
            "state": "NJ",
            "postal_code": "070411917",
            "telephone_number": "973-379-7022",
            "fax_number": "973-379-7023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALTA",
        "first_name": "WILLIAM",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2011-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00325100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P484089",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Millburn, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 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.