Individual provider Active NPI

Omerkiam Baksh, D.C.

  • Chiropractor
  • Jersey City, NJ
National Provider Identifier
1952403529
Registry record updated Jun 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00625000 Issued in NJ
Practice address
679 Montgomery St
Jersey City, NJ 07306-3324
Phone
(201) 433-7760
Fax
(201) 433-8010
NPI assigned
Sep 2, 2006
Last updated
Jun 26, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 38MC00625000 NJ Primary

Addresses

Primary practice location

679 Montgomery St
Jersey City, NJ 07306-3324

Mailing address

679 Montgomery St
Jersey City, NJ 07306-3324
Phone (201) 433-7760

Other identifiers 1

IdentifierTypeStateIssuer
0060071MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050210000146 NJ Practitioner - Chiropractic 8426009184 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Precision Pain and Spine Institute LLCGroup PAC ID 1254612591, 6 clinicians

Practice addresses (Care Compare)

679 Montgomery St
Jersey City, NJ 07306-3324
Phone (732) 444-8888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sun Up Chiropractic and Physical Therapy LLC Chiropractor CurrentSince Nov 5, 2007 Accepting new patients
Precision Pain & Spine Institute LLC CurrentSince Feb 19, 2025 Accepting new patients

Locations

1115 Clifton Ave
Clifton, NJ 07013
Phone (201) 933-3777

1255 Whitehorse Mercerville Rd
Ste 510
Hamilton, NJ 08619
Phone (732) 402-4300

679 Montgomery St
Jersey City, NJ 07306
Phone (201) 433-6500

Organizations & group practices 2

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": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214438400000",
    "number": "1952403529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "679 MONTGOMERY ST",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073063324",
            "telephone_number": "201-433-7760",
            "fax_number": "201-433-8010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "679 MONTGOMERY ST",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073063324",
            "telephone_number": "201-433-7760",
            "fax_number": "201-433-8010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKSH",
        "first_name": "OMERKIAM",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2008-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00625000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0060071",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2008; 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.