Organization Active NPI

Montclair Upper Cervical Chiropractic LLC

Doing business as Montclair Upper Cervical Chiropractic

  • Chiropractor
  • West Orange, NJ
National Provider Identifier
1679099832
Registry record updated Jun 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00742200 Issued in NJ
Legal business name
MONTCLAIR UPPER CERVICAL CHIROPRACTIC LLC
Doing business as
Montclair Upper Cervical Chiropractic
Practice address
155 Prospect Ave Ste 202
West Orange, NJ 07052-4204
Phone
(862) 520-1329
NPI assigned
Aug 19, 2017
Last updated
Jun 19, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2025

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

Authorized official

Name
Dr. Kevin PeccaNPI 1356889133
Title
Owner
Phone
(973) 744-3456

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 38MC00742200 NJ Primary

Addresses

Primary practice location

155 Prospect Ave Ste 202
West Orange, NJ 07052-4204

Mailing address

155 Prospect Ave Ste 202
West Orange, NJ 07052-4204
Phone (973) 744-3456

Other names 2

  • Montclair Upper Cervical Chiropractic Doing business as
  • Upper Cervical Health Center LLC Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180412000242 NJ Part B Supplier - Clinic/Group Practice 6002179652 Receives reassigned benefits from 2 practitioners
Practice locations: West Orange, NJ

National Provider Directory

National Provider Directory

Locations

155 Prospect Ave
Ste 202
West Orange, NJ 07052
Phone (862) 520-1329

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1503100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750291200000",
    "number": "1679099832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 PROSPECT AVE STE 202",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070524204",
            "telephone_number": "973-744-3456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 PROSPECT AVE STE 202",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070524204",
            "telephone_number": "862-520-1329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTCLAIR UPPER CERVICAL CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-19",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "status": "A",
        "authorized_official_last_name": "PECCA",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-744-3456",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00742200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Montclair Upper Cervical Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Upper Cervical Health Center LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in West Orange, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2025; 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.