Individual provider Active NPI

Moshe Laub, D.C.

  • Chiropractor
  • West Hartford, CT
National Provider Identifier
1710987789
Registry record updated Mar 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
001568 Issued in CT
Practice address
345 N Main St
Suite 322
West Hartford, CT 06117-2515
Phone
(860) 232-5556
Fax
(860) 232-5557
NPI assigned
Jul 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 001568 CT Primary

Addresses

Primary practice location

345 N Main St
Suite 322
West Hartford, CT 06117-2515

Mailing address

345 N Main St
Suite 322
West Hartford, CT 06117-2515
Phone (860) 232-5556

Other identifiers 2

IdentifierTypeStateIssuer
11443110OtherCTCAQH
050001568CT01OtherCTBC/BS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050301000280 CT Practitioner - Chiropractic 5092768135 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Canadian Memorial Chiropractic College, 1995
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

345 N Main St
Suite 322
West Hartford, CT 06117-2508
Phone (860) 232-5556

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001568CTMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
West Hartford Chiropractic LLC Chiropractor CurrentSince Jan 28, 2005 Accepting new patients

Locations

345 N Main St
Ste 322
West Hartford, CT 06117
Phone (860) 232-5556

Organizations & group practices 1

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": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204675200000",
    "number": "1710987789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 N MAIN ST",
            "address_2": "SUITE 322",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061172515",
            "telephone_number": "860-232-5556",
            "fax_number": "860-232-5557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 N MAIN ST",
            "address_2": "SUITE 322",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061172515",
            "telephone_number": "860-232-5556",
            "fax_number": "860-232-5557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUB",
        "first_name": "MOSHE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-29",
        "last_updated": "2008-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CT",
            "license": "001568",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11443110",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "050001568CT01",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hartford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2008; 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.