Organization Active NPI

Deluca Family Chiropractic PA

  • Sports Physician Chiropractor
  • Old Bridge, NJ
National Provider Identifier
1861780892
Registry record updated Jul 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
Legal business name
DELUCA FAMILY CHIROPRACTIC PA
Practice address
2309 Highway 516
Old Bridge, NJ 08857-1865
Phone
(732) 679-2414
Fax
(732) 679-1151
NPI assigned
Jul 12, 2011
Last updated
Jul 12, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2011

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

Authorized official

Name
Dr. Anthony John Deluca, D.C.NPI 1417001199
Title
Owner/Chiropractor
Phone
(732) 679-2414

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NS0005X Primary

Addresses

Primary practice location

2309 Highway 516
Old Bridge, NJ 08857-1865

Mailing address

PO Box 687
Old Bridge, NJ 08857-0687
Phone (732) 679-2414

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110713000392 NJ Part B Supplier - Clinic/Group Practice 4587832860 Receives reassigned benefits from 1 practitioner
Practice locations: Old Bridge, NJ

National Provider Directory

National Provider Directory

Locations

2309 Highway 516
Old Bridge, NJ 08857
Phone (732) 679-2414

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1310428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310428800000",
    "number": "1861780892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 687",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088570687",
            "telephone_number": "732-679-2414",
            "fax_number": "732-679-1151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2309 HIGHWAY 516",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088571865",
            "telephone_number": "732-679-2414",
            "fax_number": "732-679-1151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELUCA FAMILY CHIROPRACTIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-12",
        "last_updated": "2011-07-12",
        "status": "A",
        "authorized_official_last_name": "DELUCA",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "732-679-2414",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Bridge, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.