Active NPI
Gustavo Mejia, DC
- Chiropractor
- Bay Shore, NY
National Provider Identifier
1821289927
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- X003936
- Practice address
- 8 Maple Ave
Bay Shore, NY 11706-8722 - Phone
- (631) 968-0586
- Fax
- (631) 968-6720
- NPI assigned
- Aug 5, 2007
- Last updated
- Aug 5, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | X003936 | NY | Primary |
Addresses
Primary practice location
8 Maple Ave
Bay Shore, NY 11706-8722
Mailing address
8 Maple Ave
Bay Shore, NY 11706-8722
Phone (631) 968-0586
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| X003936 | Other | NY | LICENSE |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| X003936 | NY | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1186272000000",
"number": "1821289927",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8 MAPLE AVE",
"city": "BAY SHORE",
"state": "NY",
"postal_code": "117068722",
"telephone_number": "631-968-0586",
"fax_number": "631-968-6720"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8 MAPLE AVE",
"city": "BAY SHORE",
"state": "NY",
"postal_code": "117068722",
"telephone_number": "631-968-0586",
"fax_number": "631-968-6720"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEJIA",
"first_name": "GUSTAVO",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-08-05",
"last_updated": "2007-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NY",
"license": "X003936",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "X003936",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bay Shore, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.