Individual provider Active NPI

Robert L Brostowin, DC PC

  • Neurology Chiropractor
  • Wantagh, NY
National Provider Identifier
1720204019
Registry record updated Nov 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology ChiropractorTaxonomy code 111NN0400X
License
X006335-1 Issued in NY
Practice address
3487 Jerusalem Ave
Wantagh, NY 11793-2000
Phone
(516) 221-0900
Fax
(516) 221-0567
NPI assigned
Apr 17, 2007
Last updated
Nov 25, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Chiropractor 111NN0400X X006335-1 NY Primary

Addresses

Primary practice location

3487 Jerusalem Ave
Wantagh, NY 11793-2000

Mailing address

3487 Jerusalem Ave
Wantagh, NY 11793-2000
Phone (718) 261-6705

Other identifiers 6

IdentifierTypeStateIssuer
4165432OtherNYCIGNA
P2679219OtherNYOXFORD
020614752OtherNYGHI
3031202OtherNYAETNA
C006335-6OtherNYWORKER COMP.
5G21OtherNYEMPIRE BC BS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050715000322 NY Practitioner - Chiropractic 9931135498 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3487 Jerusalem Ave
Wantagh, NY 11793-2000
Phone (516) 221-0900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X006335-1NYMDNeurology Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Robert L. Brostowin DC PC Neurology CurrentSince Jun 12, 2005 Accepting new patients
James J. Brostowin, D.C., P.C. Neurology CurrentSince Feb 6, 2017 Accepting new patients

Locations

7150 Austin St
Ste 102
Forest Hills, NY 11375
Phone (718) 261-6705

3487 Jerusalem Ave
Wantagh, NY 11793
Phone (516) 221-0900

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574640000000",
    "number": "1720204019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3487 JERUSALEM AVE",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "117932000",
            "telephone_number": "718-261-6705",
            "fax_number": "718-261-6707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3487 JERUSALEM AVE",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "117932000",
            "telephone_number": "516-221-0900",
            "fax_number": "516-221-0567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROSTOWIN",
        "first_name": "ROBERT",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DC PC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-17",
        "last_updated": "2019-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "NY",
            "license": "X006335-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "4165432",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P2679219",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "020614752",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3031202",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKER COMP.",
            "identifier": "C006335-6",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BC BS",
            "identifier": "5G21",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wantagh, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2019; 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.