Individual provider Active NPI

Robert J. Haley, D.C.

  • Sports Physician Chiropractor
  • Lyndhurst, NJ
National Provider Identifier
1861475485
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
MC04516 Issued in NJ
Practice address
528 Valley Brook Ave
Lyndhurst, NJ 07071-1930
Phone
(201) 531-9400
Fax
(201) 531-9530
NPI assigned
Nov 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X MC04516 NJ Primary

Addresses

Primary practice location

528 Valley Brook Ave
Lyndhurst, NJ 07071-1930

Mailing address

528 Valley Brook Ave
Lyndhurst, NJ 07071-1930
Phone (201) 531-9400

Other identifiers 7

IdentifierTypeStateIssuer
6280609MedicaidNJ
938-734OtherPHS ID
UNITED HEALTHCAREOther1336065
P 663701OtherOXFORD ID
766362OtherAMERIHEALTH ID
6589432OtherCIGNA ID
X8B071OtherWELCHOICE ID

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080808000438 NJ Practitioner - Chiropractic 0648344697 Practice locations: Lyndhurst, NJ

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

528 Valley Brook Ave
Lyndhurst, NJ 07071-1930
Phone (201) 531-9400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MC04516NJMDSports Physician Chiropractor

NPI Registry JSON

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

{
    "created_epoch": "1133222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1861475485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "528 VALLEY BROOK AVE",
            "city": "LYNDHURST",
            "state": "NJ",
            "postal_code": "070711930",
            "telephone_number": "201-531-9400",
            "fax_number": "201-531-9530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "528 VALLEY BROOK AVE",
            "city": "LYNDHURST",
            "state": "NJ",
            "postal_code": "070711930",
            "telephone_number": "201-531-9400",
            "fax_number": "201-531-9530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALEY",
        "first_name": "ROBERT",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-29",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "NJ",
            "license": "MC04516",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6280609",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHS ID",
            "identifier": "938-734",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1336065",
            "identifier": "UNITED HEALTHCARE",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD ID",
            "identifier": "P 663701",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH ID",
            "identifier": "766362",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA ID",
            "identifier": "6589432",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELCHOICE ID",
            "identifier": "X8B071",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lyndhurst, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.