Individual provider Active NPI

Victor Fano, D.C.

  • Chiropractor
  • Union, NJ
National Provider Identifier
1700965142
Registry record updated Sep 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00493100 Issued in NJ
Practice address
2182 Morris Ave
Union, NJ 07083-5902
Phone
(908) 851-2666
Fax
(908) 851-2299
NPI assigned
Nov 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 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 38MC00493100 NJ Primary

Addresses

Primary practice location

2182 Morris Ave
Union, NJ 07083-5902

Mailing address

2182 Morris Avenue
Union, NJ 07083-9430
Phone (908) 851-2666

Other identifiers 1

IdentifierTypeStateIssuer
003115M3NOtherNJPROVIDER ID

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110119001267 NJ Practitioner - Chiropractic 5294820106 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Union Medical, LLCGroup PAC ID 8628015195, 2 clinicians

Practice addresses (Care Compare)

2182 Morris Ave
Union, NJ 07083-5902
Phone (908) 851-2666

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38MC00493100NJMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Union Medical, LLC Chiropractor CurrentSince Aug 27, 1996 Accepting new patients
Bloomfield Total Health Center PastSince Aug 22, 2012 Accepting new patients

Locations

2182 Morris Ave
Union, NJ 07083
Phone (908) 851-2666

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": "1162684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189987200000",
    "number": "1700965142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2182 MORRIS AVENUE",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070839430",
            "telephone_number": "908-851-2666",
            "fax_number": "908-851-2299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2182 MORRIS AVE",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070835902",
            "telephone_number": "908-851-2666",
            "fax_number": "908-851-2299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANO",
        "first_name": "VICTOR",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-05",
        "last_updated": "2007-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00493100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER ID",
            "identifier": "003115M3N",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Union, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 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.