Individual provider Active NPI

Victor C Gremli Jr., DC

  • Chiropractor
  • East Islip, NY
National Provider Identifier
1902977549
Registry record updated Apr 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
003916 Issued in NY
Practice address
55 Carleton Ave
Suite #6
East Islip, NY 11730-2133
Phone
(631) 277-7788
Fax
(631) 277-7789
NPI assigned
Nov 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 003916 NY Primary

Addresses

Primary practice location

55 Carleton Ave
Suite #6
East Islip, NY 11730-2133

Mailing address

55 Carleton Ave
Suite #6
East Islip, NY 11730-2133
Phone (631) 277-7788

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100715000319 NY Practitioner - Chiropractic 2567594237 Practice locations: East Islip, NY

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

55 Carleton Ave
East Islip, NY 11730-2133
Phone (631) 277-7788

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
003916NYMDCertified Respiratory Therapist

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270512000000",
    "number": "1902977549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 CARLETON AVE",
            "address_2": "SUITE #6",
            "city": "EAST ISLIP",
            "state": "NY",
            "postal_code": "117302133",
            "telephone_number": "631-277-7788",
            "fax_number": "631-277-7789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 CARLETON AVE",
            "address_2": "SUITE #6",
            "city": "EAST ISLIP",
            "state": "NY",
            "postal_code": "117302133",
            "telephone_number": "631-277-7788",
            "fax_number": "631-277-7789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREMLI",
        "first_name": "VICTOR",
        "middle_name": "C",
        "name_suffix": "Jr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2010-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "003916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Islip, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2010; 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.