Individual provider Active NPI

Mohamed Jamil Munassar, DC

  • Nutrition Chiropractor
  • West Seneca, NY
National Provider Identifier
1740599877
Registry record updated Jun 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition ChiropractorTaxonomy code 111NN1001X
License
X011908-1 Issued in NY
Practice address
4214 Clinton St
West Seneca, NY 14224-5877
Phone
(716) 903-0008
NPI assigned
Oct 7, 2010
Last updated
Jun 21, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Chiropractor 111NN1001X X011908-1 NY Primary

Addresses

Primary practice location

4214 Clinton St
West Seneca, NY 14224-5877

Mailing address

4214 Clinton St
West Seneca, NY 14224-5877
Phone (716) 903-0008

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110802000015 NY Practitioner - Chiropractic 1850560202 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4214 Clinton St
West Seneca, NY 14224-1606
Phone (716) 675-2225

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X011908-1NYMDNutrition Chiropractor
011908NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Chiro One Wellness P. C. Nutrition CurrentSince Aug 1, 2011 Accepting new patients

Locations

4214 Clinton St
West Seneca, NY 14224
Phone (716) 675-2225

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": "1286409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308614400000",
    "number": "1740599877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4214 CLINTON ST",
            "city": "WEST SENECA",
            "state": "NY",
            "postal_code": "142245877",
            "telephone_number": "716-903-0008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4214 CLINTON ST",
            "city": "WEST SENECA",
            "state": "NY",
            "postal_code": "142245877",
            "telephone_number": "716-903-0008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNASSAR",
        "first_name": "MOHAMED",
        "middle_name": "JAMIL",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-07",
        "last_updated": "2011-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "NY",
            "license": "X011908-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Seneca, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2011; 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.