Kevin Pavlak, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

38MC00750700 Issued in NJ

Practice address

18 Newark Pompton Tpke
Riverdale, NJ 07457-1141

Phone

(197) 361-6455

Fax

(973) 616-4555

NPI assigned

Jan 26, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Chiropractic

Education

New York Chiropractic College, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Therapy and ChiropracticGroup PAC ID 3375934987, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Advanced Therapy and Chiropractic

  • Chiropractor
  • Riverdale, NJ
  • NPI 1699431395
  Medicare reassignment Care Compare group NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1516924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516924800000",
    "number": "1831697697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 CENTER ST",
            "city": "BUTLER",
            "state": "NJ",
            "postal_code": "074051331",
            "telephone_number": "862-377-9802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 NEWARK POMPTON TPKE",
            "city": "RIVERDALE",
            "state": "NJ",
            "postal_code": "074571141",
            "telephone_number": "197-361-6455",
            "fax_number": "973-616-4555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAVLAK",
        "first_name": "KEVIN",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-26",
        "last_updated": "2018-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00750700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Open MRI Centers of New Jersey, LLC
• Open MRI of Warren LLLC
• Joanna Paganotti
• Hailey Panella, LPC
• Johanna T Parisi
• Pearle Vision Riverdale/Relm Opticians,LLC
• Maryann Pladdys, AU.D.
• Meagan Poehlmann, PT, DPT
• Pompton Dental Arts LLC
• Pompton Dental Arts of Riverdale LLC

• Chiropractor in Riverdale, NJ
• Providers in Riverdale, NJ by specialty
• Chiropractor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2018; 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.