Individual provider Active NPI

Jorge Mena, DC

  • Chiropractor
  • Corona, NY
National Provider Identifier
1669935847
Registry record updated Apr 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
007356 Issued in NY
Practice address
9632 Corona Ave
Corona, NY 11368-2733
Phone
(917) 720-6449
NPI assigned
Apr 13, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 007356 NY Primary

Addresses

Primary practice location

9632 Corona Ave
Corona, NY 11368-2733

Mailing address

9632 Corona Ave
Corona, NY 11368-2733
Phone (917) 720-6449

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
007356NYMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1555113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555113600000",
    "number": "1669935847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9632 CORONA AVE",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "113682733",
            "telephone_number": "917-720-6449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9632 CORONA AVE",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "113682733",
            "telephone_number": "917-720-6449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENA",
        "first_name": "JORGE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-13",
        "last_updated": "2019-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "007356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.