Individual provider Active NPI

John J Obrien, DC

  • Chiropractor
  • Troy, NY
National Provider Identifier
1801984877
Registry record updated Aug 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X0066141 Issued in NY
Practice address
492 Pawling Ave
Troy, NY 12180-5834
Phone
(518) 286-3060
Fax
(518) 286-3044
NPI assigned
Oct 11, 2006
Last updated
Aug 24, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X0066141 NY Primary

Addresses

Primary practice location

492 Pawling Ave
Troy, NY 12180-5834

Mailing address

492 Pawling Ave
Troy, NY 12180-5834
Phone (518) 286-3060

Other identifiers 5

IdentifierTypeStateIssuer
98L1915OtherNYMVP
X54101OtherBLUE CROSS BLUE SHIELD
C066144OtherNYWORKERS COMPENSATION
10021222OtherNYCDPHP
607980OtherNYMPN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091113000021 NY Practitioner - Chiropractic 4981742848 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

492 Pawling Ave
Troy, NY 12180-5834
Phone (518) 286-3060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6614NYMDGroup Psychotherapy Psychologist
X0066141NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Wynantskill Chiropractic PC Chiropractor CurrentSince May 25, 2010 Accepting new patients

Locations

492 Pawling Ave
Troy, NY 12180
Phone (518) 286-3060

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": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251072000000",
    "number": "1801984877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "492 PAWLING AVE",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121805834",
            "telephone_number": "518-286-3060",
            "fax_number": "518-286-3044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "492 PAWLING AVE",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121805834",
            "telephone_number": "518-286-3060",
            "fax_number": "518-286-3044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBRIEN",
        "first_name": "JOHN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2009-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X0066141",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "98L1915",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "X54101",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS COMPENSATION",
            "identifier": "C066144",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPHP",
            "identifier": "10021222",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MPN",
            "identifier": "607980",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2009; 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.