Individual provider Active NPI

Robert Joseph Altenburger, DC

  • Chiropractor
  • Port Jefferson Station, NY
National Provider Identifier
1841405693
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X0027701 Issued in NY
Practice address
379 Old Town Rd
Port Jefferson Station, NY 11776-2245
Phone
(631) 473-4320
Fax
(631) 928-8340
NPI assigned
May 14, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X0027701 NY Primary

Addresses

Primary practice location

379 Old Town Rd
Port Jefferson Station, NY 11776-2245

Mailing address

379 Old Town Rd
Port Jefferson Station, NY 11776-2245
Phone (631) 473-4320

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

LicenseStateTypeSpecialty
X0027701NYMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841405693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "379 OLD TOWN RD",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117762245",
            "telephone_number": "631-473-4320",
            "fax_number": "631-928-8340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "379 OLD TOWN RD",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117762245",
            "telephone_number": "631-473-4320",
            "fax_number": "631-928-8340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALTENBURGER",
        "first_name": "ROBERT",
        "middle_name": "JOSEPH",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X0027701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson Station, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.