Individual provider Active NPI

Zachary Alexander Nowicki, DC

  • Chiropractor
  • East Islip, NY
National Provider Identifier
1922663095
Registry record updated Mar 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
013155 Issued in NY
Practice address
369 E Main St Ste 6
East Islip, NY 11730-2800
Phone
(631) 968-8300
NPI assigned
May 4, 2019
Last updated
Mar 27, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X013155 NY
Chiropractor 111N00000X 013155 NY Primary

Addresses

Primary practice location

369 E Main St Ste 6
East Islip, NY 11730-2800

Mailing address

12 Amboy LN
Lake Grove, NY 11755-2502
Phone (631) 418-6378

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200312000053 NY Practitioner - Chiropractic 9830527563 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2018
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

369 E Main St
Suite 6
East Islip, NY 11730-2800
Phone (631) 968-8300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X013155NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Joanna Fasulo DC PC Chiropractor CurrentSince Feb 20, 2020 Accepting new patients
Saxon Chiropractic & Adult Health NP, PLLC Chiropractor CurrentSince Dec 1, 2024 Accepting new patients
Saxon Chiropractic & Adult Health NP, PLLC Chiropractor CurrentSince Dec 1, 2024 Accepting new patients
Within Normal Limits Physical Therapy P.C. Past Accepting new patients

Locations

369 E Main St
Ste 6
East Islip, NY 11730
Phone (631) 968-8300

680 Route 112
Ste C
Patchogue, NY 11772
Phone (631) 289-3939

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": "1556928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743033600000",
    "number": "1922663095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 AMBOY LN",
            "city": "LAKE GROVE",
            "state": "NY",
            "postal_code": "117552502",
            "telephone_number": "631-418-6378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "369 E MAIN ST STE 6",
            "city": "EAST ISLIP",
            "state": "NY",
            "postal_code": "117302800",
            "telephone_number": "631-968-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOWICKI",
        "first_name": "ZACHARY",
        "middle_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-04",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X013155",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "013155",
            "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 Mar 27, 2025; 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.