Robert T. Buis, DC
Individual provider Active NPI Chiropractor · Hawthorne, NJ
NPI 1902970072 · NPPES record last updated Oct 31, 2007
Key facts
- NPI
- 1902970072
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 38MC00336100 (NJ)
- Practice address
- 674 Lafayette Ave
Hawthorne, NJ 07506-2344 - Phone
- (973) 423-2116
- Fax
- (973) 423-4114
- NPI assigned
- Nov 20, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Life Chiropractic College - West, 1986
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
579 Goffle Rd
Wyckoff, NJ 07481-2946
Phone (973) 423-2116
674 Lafayette Ave
Hawthorne, NJ 07506-2344
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080328000171 | NJ | Practitioner - Chiropractic | 2163508359 | Practice locations: Wyckoff, NJ |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38MC00336100 | NJ | MD | Chiropractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 38MC00336100 | NJ | Yes |
Addresses
Primary practice location
674 Lafayette Ave
Hawthorne, NJ 07506-2344
Mailing address
674 Lafayette Ave
Hawthorne, NJ 07506-2344
Phone (973) 423-2116
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4241164 | Other | NJ | AETNA TRADITIONAL |
| 25958 | Other | NJ | AETNA HMO |
| P2753913 | Other | NJ | OXFORD |
Other providers in Hawthorne, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 31, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.