Individual provider Active NPI

Kevin Bradley Collins, DC

  • Chiropractor
  • Queensbury, NY
National Provider Identifier
1750102927
Registry record updated Feb 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
013934 Issued in NY
Practice address
395 Bay Rd
Queensbury, NY 12804-1405
Phone
(518) 793-1205
Fax
(518) 793-1515
NPI assigned
Oct 21, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 013934 NY Primary

Addresses

Primary practice location

395 Bay Rd
Queensbury, NY 12804-1405

Mailing address

395 Bay Rd
Queensbury, NY 12804-1405
Phone (518) 793-1205

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250220001356 NY Practitioner - Chiropractic 6305366360 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oleary Chiropractic PLLCGroup PAC ID 8325007800, 3 clinicians

Practice addresses (Care Compare)

395 Bay Rd
Queensbury, NY 12804-1405
Phone (518) 793-1205

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
013934NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
O'Leary Chiropractic, PLLC Chiropractor CurrentSince Feb 17, 2025 Accepting new patients

Locations

395 Bay Rd
Queensbury, NY 12804
Phone (518) 743-0491

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": "1729468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739404800000",
    "number": "1750102927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "395 BAY RD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128041405",
            "telephone_number": "518-793-1205",
            "fax_number": "518-793-1515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 BAY RD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128041405",
            "telephone_number": "518-793-1205",
            "fax_number": "518-793-1515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "KEVIN",
        "middle_name": "BRADLEY",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-21",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "013934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Queensbury, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2025; 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.