Individual provider Active NPI

Steven Robert Nissenbaum, DC

  • Chiropractor
  • Richmond Hill, NY
National Provider Identifier
1780643965
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X2059 Issued in NY
Practice address
105-09 Jamaica Ave
Ste a
Richmond Hill, NY 11418
Phone
(718) 441-9390
Fax
(718) 441-1061
NPI assigned
Mar 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X2059 NY Primary

Addresses

Primary practice location

105-09 Jamaica Ave
Ste a
Richmond Hill, NY 11418

Mailing address

105-09 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 441-9390

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070328000027 NY Practitioner - Chiropractic 3072617430 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X2059NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Associates of Richmond Hill PC Chiropractor CurrentSince Dec 29, 1994 Accepting new patients
Synergy Physical Therapy & Chiropractic PLLC Chiropractor PastSince May 26, 2018 Accepting new patients
Kanter Physical Medicine & Rehab PC Past Accepting new patients

Locations

10509 Jamaica Ave
Ste A
Richmond Hill, NY 11418
Phone (718) 441-9390

10509 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 441-3211

Organizations & group practices 3

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": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1780643965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105-09 JAMAICA AVE",
            "city": "RICHMOND HILL",
            "state": "NY",
            "postal_code": "11418",
            "telephone_number": "718-441-9390",
            "fax_number": "718-441-1061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105-09 JAMAICA AVE",
            "address_2": "STE A",
            "city": "RICHMOND HILL",
            "state": "NY",
            "postal_code": "11418",
            "telephone_number": "718-441-9390",
            "fax_number": "718-441-1061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISSENBAUM",
        "first_name": "STEVEN",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X2059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond Hill, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.