Individual provider Active NPI

Inna S Trakhtenberg, D.C.

  • Chiropractor
  • Hallandale Beach, FL
National Provider Identifier
1851430102
Registry record updated Dec 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH-11660 Issued in FL
Practice address
2500 E Hallandale Beach Blvd Ste 406
Hallandale Beach, FL 33009-4837
Phone
(954) 990-0302
Fax
(954) 908-7101
NPI assigned
Feb 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH-11660 FL Primary

Addresses

Primary practice location

2500 E Hallandale Beach Blvd Ste 406
Hallandale Beach, FL 33009-4837

Mailing address

225 179TH Dr Apt 201
Sunny Isles Beach, FL 33160-1934
Phone (404) 522-5552

Other identifiers 1

IdentifierTypeStateIssuer
1851430102OtherGACHIROPRACTOR/NUTRITIONIST

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190426000871 FL Practitioner - Chiropractic 1951458314 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ageless Body by New Science LLCGroup PAC ID 5991047789, 4 clinicians

Practice addresses (Care Compare)

2500 E Hallandale Beach Blvd
Hallandale Beach, FL 33009-4837
Phone (954) 990-0302

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH-11660FLMDChiropractor
7312GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ageless Body by New Science LLC CurrentSince Mar 27, 2019 Accepting new patients
Ageless Body Clinic, LLC Current Accepting new patients
Medprime, LLC Chiropractor Past Accepting new patients
Medprime, LLC Chiropractor PastSince Jan 28, 2013 Accepting new patients

Locations

2500 E Hallandale Beach Blvd
Ste 406
Hallandale Beach, FL 33009
Phone (718) 968-5637

Organizations & group practices 4

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": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543968000000",
    "number": "1851430102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 179TH DR APT 201",
            "city": "SUNNY ISLES BEACH",
            "state": "FL",
            "postal_code": "331601934",
            "telephone_number": "404-522-5552",
            "fax_number": "404-522-5151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 E HALLANDALE BEACH BLVD STE 406",
            "city": "HALLANDALE BEACH",
            "state": "FL",
            "postal_code": "330094837",
            "telephone_number": "954-990-0302",
            "fax_number": "954-908-7101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAKHTENBERG",
        "first_name": "INNA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-05",
        "last_updated": "2018-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH-11660",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIROPRACTOR/NUTRITIONIST",
            "identifier": "1851430102",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hallandale Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.