Individual provider Active NPI

Elliot J Martin, DC

  • Chiropractor
  • Valatie, NY
National Provider Identifier
1851433437
Registry record updated Apr 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X007068 Issued in NY
Practice address
2139 County Route 21
Valatie, NY 12184-3116
Phone
(518) 697-9701
NPI assigned
Feb 12, 2007
Last updated
Apr 3, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 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 X007068 NY Primary

Addresses

Primary practice location

2139 County Route 21
Valatie, NY 12184-3116

Mailing address

2139 County Route 21
Valatie, NY 12184-3116
Phone (518) 697-9701

Other identifiers 1

IdentifierTypeStateIssuer
X007068OtherNYLICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120118000629 NY Practitioner - Chiropractic 4082770532 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2139 County Route 21
Valatie, NY 12184-3116
Phone (518) 697-9701

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7068NYMDMental Health Counselor
X007068NYMDChiropractor
007068NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
East Gate Chiropractic PC Chiropractor CurrentSince Apr 3, 2021 Accepting new patients
Nassau Medical Supply, Inc. Current Accepting new patients
Queens Rehabilitation & Diagnostics Past Accepting new patients
Neurological Services of Queens, P.C. Past Accepting new patients

Locations

3143 US Highway 9
Ste 4
Valatie, NY 12184
Phone (518) 697-9701

Organizations & group practices 5

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": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522713600000",
    "number": "1851433437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2139 COUNTY ROUTE 21",
            "city": "VALATIE",
            "state": "NY",
            "postal_code": "121843116",
            "telephone_number": "518-697-9701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2139 COUNTY ROUTE 21",
            "city": "VALATIE",
            "state": "NY",
            "postal_code": "121843116",
            "telephone_number": "518-697-9701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "ELLIOT",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2018-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X007068",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "X007068",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valatie, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 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.