Individual provider Active NPI

Mark A Krele, DC CHIROPRACTOR

  • Chiropractor
  • Flushing, NY
National Provider Identifier
1790870640
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X0064021 Issued in NY
Practice address
147 19 Hawthorne Ave
Flushing, NY 11355-1715
Phone
(718) 460-2441
NPI assigned
Oct 4, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X0064021 NY Primary

Addresses

Primary practice location

147 19 Hawthorne Ave
Flushing, NY 11355-1715

Mailing address

147 19 Hawthorne Ave
Flushing, NY 11355-1715
Phone (718) 460-2441

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110119000964 NY Practitioner - Chiropractic 4486833746 Practice locations: Flushing, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X0064021NYMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790870640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 19 HAWTHORNE AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113551715",
            "telephone_number": "718-460-2441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 19 HAWTHORNE AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113551715",
            "telephone_number": "718-460-2441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRELE",
        "first_name": "MARK",
        "middle_name": "A",
        "credential": "DC CHIROPRACTOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X0064021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.