Individual provider Active NPI

Maris Stella Fraga, D.C.

  • Chiropractor
  • Bayonne, NJ
National Provider Identifier
1811372816
Registry record updated Mar 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00728400 Issued in NJ
Practice address
120 Lefante Way
Bayonne, NJ 07002-5060
Phone
(201) 858-0444
Fax
(201) 858-4049
NPI assigned
Jul 20, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 38MC00728400 NJ Primary

Addresses

Primary practice location

120 Lefante Way
Bayonne, NJ 07002-5060

Mailing address

120 Lefante Way
Bayonne, NJ 07002-5060
Phone (201) 858-0444

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150921001207 NJ Practitioner - Chiropractic 3779890926 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fraga Wellness Solutions PCGroup PAC ID 9436466687, 2 clinicians

Practice addresses (Care Compare)

120 Lefante Way
Bayonne, NJ 07002-5060
Phone (201) 858-0444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38MC00728400NJMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Fraga Wellness Solutions, PC Chiropractor CurrentSince Jul 22, 2015 Accepting new patients

Locations

120 Lefante Way
Ste 3
Bayonne, NJ 07002

120 Lefante Way
Bayonne, NJ 07002
Phone (201) 339-2500

734 Broadway
Bayonne, NJ 07002
Phone (201) 437-0033

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": "1437350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1811372816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 LEFANTE WAY",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070025060",
            "telephone_number": "201-858-0444",
            "fax_number": "201-858-4049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 LEFANTE WAY",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070025060",
            "telephone_number": "201-858-0444",
            "fax_number": "201-858-4049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAGA",
        "first_name": "MARIS STELLA",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-20",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00728400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayonne, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2024; 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.