Individual provider Active NPI

Reginald Boenig, DO

  • Chiropractor
  • Red Hook, NY
National Provider Identifier
1861401978
Registry record updated Jan 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
006351 Issued in NY
Practice address
7592 N Broadway
Red Hook, NY 12571-1458
Phone
(845) 342-0746
Fax
(845) 342-2739
NPI assigned
Aug 7, 2006
Last updated
Jan 9, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 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 006351 NY Primary

Addresses

Primary practice location

7592 N Broadway
Red Hook, NY 12571-1458

Mailing address

7592 N Broadway
Red Hook, NY 12571-1458
Phone (845) 342-0746

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071101000573 NY Practitioner - Chiropractic 8527155951 Practice locations: Red Hook, NY

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6 Tobacco LN
Suite D
Red Hook, NY 12571-1744
Phone (845) 758-4218

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
006351NYMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Brandon Burkley Chiropractic PC Chiropractor Past Accepting new patients
Dolson Avenue Medical Chiropractor Past Accepting new patients
Physical Therapy & Chiropractic of Middletown, PLLC Past Accepting new patients
Middletown Chiropractic PC PastSince Jan 2, 2007 Accepting new patients

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, 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": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515456000000",
    "number": "1861401978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7592 N BROADWAY",
            "city": "RED HOOK",
            "state": "NY",
            "postal_code": "125711458",
            "telephone_number": "845-342-0746",
            "fax_number": "845-342-2739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7592 N BROADWAY",
            "city": "RED HOOK",
            "state": "NY",
            "postal_code": "125711458",
            "telephone_number": "845-342-0746",
            "fax_number": "845-342-2739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOENIG",
        "first_name": "REGINALD",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-07",
        "last_updated": "2018-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "006351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Red Hook, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 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.