Individual provider Active NPI

Jack A. Atzmon

  • Chiropractor
  • Riverdale, NJ
National Provider Identifier
1962565648
Registry record updated May 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00705700 Issued in NJ
Practice address
47 Hamburg Tpke
Riverdale, NJ 07457-1127
Phone
(973) 874-7777
Fax
(973) 341-7791
NPI assigned
Dec 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 38MC00705700 NJ Primary
Chiropractor 111N00000X X007493 NY

Addresses

Primary practice location

47 Hamburg Tpke
Riverdale, NJ 07457-1127

Mailing address

47 Hamburg Tpke
Riverdale, NJ 07457-1127
Phone (973) 874-9777

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130506000405 NJ Practitioner - Chiropractic 5799922043 Reassigns benefits to 1 organization
Practice locations: Riverdale, NJ

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38MC00705700NJMDChiropractor
X007493NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
NJ Custom Bracing CurrentSince Jun 9, 2024 Accepting new patients
Atzmon Chiropractic and Health Center LLC Chiropractor CurrentSince Apr 23, 2019 Accepting new patients
Allianze Medical Group PC Chiropractor Past Accepting new patients
Allcare Physical Therapy & Wellness, LLC Chiropractor Past Accepting new patients

Locations

169 Union Blvd
Fl 2
Totowa, NJ 07512
Phone (973) 847-9777

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BDGEDD/Endpoint/BDGEDD

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716076800000",
    "number": "1962565648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 HAMBURG TPKE",
            "city": "RIVERDALE",
            "state": "NJ",
            "postal_code": "074571127",
            "telephone_number": "973-874-9777",
            "fax_number": "973-341-7791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 HAMBURG TPKE",
            "city": "RIVERDALE",
            "state": "NJ",
            "postal_code": "074571127",
            "telephone_number": "973-874-7777",
            "fax_number": "973-341-7791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATZMON",
        "first_name": "JACK",
        "middle_name": "A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-18",
        "last_updated": "2024-05-19",
        "certification_date": "2024-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00705700",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X007493",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverdale, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2024; 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.