Individual provider Active NPI

Jonathan Dale, D.C.

  • Chiropractor
  • Midland Park, NJ
National Provider Identifier
1679987614
Registry record updated Dec 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00714100 Issued in NJ
Practice address
666 Godwin Ave Ste 110
Midland Park, NJ 07432-1463
Phone
(201) 444-3004
NPI assigned
Jun 18, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 38MC00714100 NJ Primary

Addresses

Primary practice location

666 Godwin Ave Ste 110
Midland Park, NJ 07432-1463

Mailing address

666 Godwin Ave Ste 110
Midland Park, NJ 07432-1463
Phone (201) 444-3004

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211230001824 NJ Practitioner - Chiropractic 7719378728 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

666 Godwin Ave
Suite 110
Midland Park, NJ 07432-1463
Phone (201) 444-3004

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dale Family Chiropractic LLC Chiropractor CurrentSince Jan 1, 2022 Accepting new patients
John M Dale D C LLC Chiropractor PastSince Jan 1, 2022 Accepting new patients

Locations

666 Godwin Ave
Ste 110
Midland Park, NJ 07432
Phone (201) 444-3004

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1403049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1679987614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "666 GODWIN AVE STE 110",
            "city": "MIDLAND PARK",
            "state": "NJ",
            "postal_code": "074321463",
            "telephone_number": "201-444-3004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "666 GODWIN AVE STE 110",
            "city": "MIDLAND PARK",
            "state": "NJ",
            "postal_code": "074321463",
            "telephone_number": "201-444-3004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALE",
        "first_name": "JONATHAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-18",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00714100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland Park, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2021; 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.