Individual provider Active NPI

Andrew M. Rodgers, DC

  • Chiropractor
  • Fort Lee, NJ
National Provider Identifier
1700959509
Registry record updated Nov 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Practice address
530 Main St
Fort Lee, NJ 07024-4506
Phone
(201) 592-6200
Fax
(201) 592-6401
NPI assigned
Nov 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NJ Primary

Addresses

Primary practice location

530 Main St
Fort Lee, NJ 07024-4506

Mailing address

530 Main St
Fort Lee, NJ 07024-4506
Phone (201) 592-6200

Other identifiers 1

IdentifierTypeStateIssuer
5000009MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120626000376 NJ Practitioner - Chiropractic 2668405424 Practice locations: Fort Lee, NJ

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

530 Main St
Fort Lee, NJ 07024-4505
Phone (201) 592-6200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38MC0014100NJMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Fort Lee Rehabilitation CurrentSince May 2, 2012 Accepting new patients
Andrew M Rodgers Chiropractor CurrentSince Aug 28, 1991 Accepting new patients

Locations

530 Main St
Ste 2
Fort Lee, NJ 07024
Phone (201) 592-6200

530 Main St
Ste 3
Fort Lee, NJ 07024
Phone (201) 592-6200

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": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195084800000",
    "number": "1700959509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 MAIN ST",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070244506",
            "telephone_number": "201-592-6200",
            "fax_number": "201-592-6401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 MAIN ST",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070244506",
            "telephone_number": "201-592-6200",
            "fax_number": "201-592-6401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODGERS",
        "first_name": "ANDREW",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2007-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5000009",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lee, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2007; 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.