Individual provider Active NPI

M Vanvolkenburg Jr., DC

  • Chiropractor
  • Amherst, NY
National Provider Identifier
1831651777
Registry record updated Apr 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
013126 Issued in NY
Practice address
2140 Eggert Rd Ste B
Amherst, NY 14226-2055
Phone
(716) 832-1818
NPI assigned
Apr 1, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 013126 NY Primary

Addresses

Primary practice location

2140 Eggert Rd Ste B
Amherst, NY 14226-2055

Mailing address

2140 Eggert Rd Ste B
Amherst, NY 14226-2055
Phone (716) 832-1818

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190624000865 NY Practitioner - Chiropractic 1153655220 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
August J Domenico Jr DCGroup PAC ID 2264456102, 4 clinicians

Practice addresses (Care Compare)

6612 Lincoln Ave
Lockport, NY 14094-6109
Phone (716) 433-1322

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
013126NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
August J. Domenico Jr. DC Chiropractor CurrentSince Mar 1, 2023 Accepting new patients
David J. Lewis DC PC Chiropractor CurrentSince Dec 30, 2023 Accepting new patients

Locations

6612 Lincoln Ave
Lockport, NY 14094
Phone (716) 243-6154

3000 Military Rd
Niagara Falls, NY 14304
Phone (716) 298-5611

Organizations & group practices 2

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": "1554076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554076800000",
    "number": "1831651777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2140 EGGERT RD STE B",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142262055",
            "telephone_number": "716-832-1818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2140 EGGERT RD STE B",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142262055",
            "telephone_number": "716-832-1818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANVOLKENBURG",
        "first_name": "M",
        "name_suffix": "Jr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-01",
        "last_updated": "2019-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "013126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amherst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2019; 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.