Individual provider Active NPI

Robert Mazal, D.C.

  • Chiropractor
  • Monroe, CT
National Provider Identifier
1851414528
Registry record updated Feb 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
001586 Issued in CT
Practice address
501 Main St
Monroe, CT 06468-1116
Phone
(203) 845-0400
NPI assigned
Apr 9, 2007
Last updated
Feb 12, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 001586 CT Primary

Addresses

Primary practice location

501 Main St
Monroe, CT 06468-1116

Mailing address

360 Westport Ave
Suite 3
Norwalk, CT 06851-4348
Phone (203) 650-3489

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111025000912 NC Practitioner - Chiropractic 6800863937 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolinas CC Chiropractic PLLCGroup PAC ID 5991847949, 5 clinicians

Practice addresses (Care Compare)

101 G Waxhaw Prof PK Dr
Waxhaw, NC 28173-0501
Phone (704) 243-1010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001586CTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas CC Chiropractic PLLC Chiropractor CurrentSince Oct 1, 2020 Accepting new patients
Advanced Regenerative Care of Charlotte, PLLC CurrentSince Feb 16, 2020 Accepting new patients

Locations

10734B Monroe Rd
Matthews, NC 28105
Phone (704) 463-8180

101 Waxhaw Pkwy
#G
Waxhaw, NC 28173
Phone (704) 243-1010

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265932800000",
    "number": "1851414528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 WESTPORT AVE",
            "address_2": "SUITE 3",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068514348",
            "telephone_number": "203-650-3489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 MAIN ST",
            "city": "MONROE",
            "state": "CT",
            "postal_code": "064681116",
            "telephone_number": "203-845-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZAL",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-09",
        "last_updated": "2010-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CT",
            "license": "001586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2010; 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.