Individual provider Active NPI

Robert A Strange, DC LAC

  • Chiropractor
  • Millbrook, NY
National Provider Identifier
1962572883
Registry record updated Mar 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X004397-1 Issued in NY
Practice address
3 Merritt Ave.
Millbrook, NY 12545-0725
Phone
(845) 677-5410
Fax
(845) 677-4163
NPI assigned
Nov 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X004397-1 NY Primary
Acupuncturist 171100000X 003463-1 NY

Addresses

Primary practice location

3 Merritt Ave.
Millbrook, NY 12545-0725

Mailing address

3 Merritt Ave.
PO Box 725
Millbrook, NY 12545-0725
Phone (845) 677-5410

Other identifiers 4

IdentifierTypeStateIssuer
7233K2OtherNYBLUECROSS/ BLUE SHIELD
4397-8BOtherNYWORK COMP BOARD
820148OtherNYMANAGED PHYSICAL NETWORK
X32R71OtherNYBLUE CROSS/ BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041115000083 NY Practitioner - Chiropractic 0840254454 Practice locations: Millbrook, NY

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3 Elm Dr
Millbrook, NY 12545-0725
Phone (845) 677-5410

PO Box
Millbrook, NY 12545-0725

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
X004397-1NYMDChiropractor
003463-1NYMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301011200000",
    "number": "1962572883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 MERRITT AVE.",
            "address_2": "PO BOX 725",
            "city": "MILLBROOK",
            "state": "NY",
            "postal_code": "125450725",
            "telephone_number": "845-677-5410",
            "fax_number": "845-677-4163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 MERRITT AVE.",
            "city": "MILLBROOK",
            "state": "NY",
            "postal_code": "125450725",
            "telephone_number": "845-677-5410",
            "fax_number": "845-677-4163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRANGE",
        "first_name": "ROBERT",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DC LAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2011-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X004397-1",
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NY",
            "license": "003463-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS/ BLUE SHIELD",
            "identifier": "7233K2",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORK COMP BOARD",
            "identifier": "4397-8B",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MANAGED PHYSICAL NETWORK",
            "identifier": "820148",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/ BLUE SHIELD",
            "identifier": "X32R71",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Millbrook, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2011; 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.