Individual provider Active NPI

Pat Pagnotta, DC

  • Chiropractor
  • Pine Beach, NJ
National Provider Identifier
1689625915
Registry record updated Oct 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00318900 Issued in NJ
Practice address
101 Chelsea Ave
Pine Beach, NJ 08741-1409
Phone
(732) 341-5954
Fax
(732) 341-5955
NPI assigned
May 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 38MC00318900 NJ Primary

Addresses

Primary practice location

101 Chelsea Ave
Pine Beach, NJ 08741-1409

Mailing address

101 Chelsea Ave
Pine Beach, NJ 08741-1409
Phone (732) 341-5954

Other identifiers 1

IdentifierTypeStateIssuer
811154648OtherNJTAX IDENTIFICATION NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040115000017 NJ Practitioner - Chiropractic 2860393774 Reassigns benefits to 1 organization
Practice locations: Pine Beach, NJ

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

101 Chelsea Ave
Pine Beach, NJ 08741-1409
Phone (732) 341-5954

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38MC00318900NJMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Andrew Pagnotta DCPC Chiropractor CurrentSince Jun 23, 2016 Accepting new patients
Seaport Chiropractic Center Chiropractor Past Accepting new patients
Andrew Pagnotta DCPC Chiropractor PastSince Jun 23, 2016 Accepting new patients
Dr. Andrew Pagnotta D.C., P.C. Chiropractor PastSince Oct 1, 2007 Accepting new patients
O'Rourke Family Chiropractic , LLC Chiropractor Past Accepting new patients

Organizations & group practices 5

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": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477353600000",
    "number": "1689625915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 CHELSEA AVE",
            "city": "PINE BEACH",
            "state": "NJ",
            "postal_code": "087411409",
            "telephone_number": "732-341-5954",
            "fax_number": "732-341-5955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CHELSEA AVE",
            "city": "PINE BEACH",
            "state": "NJ",
            "postal_code": "087411409",
            "telephone_number": "732-341-5954",
            "fax_number": "732-341-5955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAGNOTTA",
        "first_name": "PAT",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2016-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00318900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX IDENTIFICATION NUMBER",
            "identifier": "811154648",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pine Beach, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2016; 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.