Individual provider Active NPI

Peter M. Marinkovic

  • Chiropractor
  • Paramus, NJ
National Provider Identifier
1801942313
Registry record updated Dec 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
MC00628900 Issued in NJ
Practice address
107 S Farview Ave
Suite C
Paramus, NJ 07652-2501
Phone
(201) 909-0502
Fax
(201) 909-0377
NPI assigned
Jan 26, 2007
Last updated
Dec 15, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X MC00628900 NJ Primary

Addresses

Primary practice location

107 S Farview Ave
Suite C
Paramus, NJ 07652-2501

Mailing address

107 S Farview Ave
Suite C
Paramus, NJ 07652-2501
Phone (201) 909-0502

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MC00628900NJMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Marinkovic Chiropractic Chiropractor PastSince Feb 5, 2017 Accepting new patients

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, 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": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418601600000",
    "number": "1801942313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 S FARVIEW AVE",
            "address_2": "SUITE C",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076522501",
            "telephone_number": "201-909-0502",
            "fax_number": "201-909-0377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 S FARVIEW AVE",
            "address_2": "SUITE C",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076522501",
            "telephone_number": "201-909-0502",
            "fax_number": "201-909-0377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARINKOVIC",
        "first_name": "PETER",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2014-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "MC00628900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paramus, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.