NPIMap

Organization Active NPI

Brielle Integrated Healthcare LLC

  • Chiropractor
  • Brielle, NJ
National Provider Identifier
1962915504
Registry record updated Nov 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
BRIELLE INTEGRATED HEALTHCARE LLC
Practice address
629 Higgins Ave
Brielle, NJ 08730-1427
Phone
(732) 872-6595
NPI assigned
Nov 6, 2017
Last updated
Nov 6, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2017

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

Authorized official

Name
John J MazzellaNPI 1235275074
Title
Owner
Phone
(732) 872-6595

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU Primary
Acupuncturist 171100000X NU
Physical Therapist 225100000X NU

Addresses

Primary practice location

629 Higgins Ave
Brielle, NJ 08730-1427

Mailing address

2373 Highway 36
Atlantic Highlands, NJ 07716-2560
Phone (732) 872-6595

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171214001060 NJ Part B Supplier - Clinic/Group Practice 5395003602 Receives reassigned benefits from 12 practitioners
Practice locations: Brielle, NJ

National Provider Directory

National Provider Directory

Locations

629 Higgins Ave
Brielle, NJ 08730
Phone (732) 292-9900

629 Higgins Ave
Ste 2
Brielle, NJ 08730
Phone (732) 872-6595

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1509926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509926400000",
    "number": "1962915504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2373 HIGHWAY 36",
            "city": "ATLANTIC HIGHLANDS",
            "state": "NJ",
            "postal_code": "077162560",
            "telephone_number": "732-872-6595",
            "fax_number": "732-872-1508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 HIGGINS AVE",
            "city": "BRIELLE",
            "state": "NJ",
            "postal_code": "087301427",
            "telephone_number": "732-872-6595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIELLE INTEGRATED HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-06",
        "last_updated": "2017-11-06",
        "status": "A",
        "authorized_official_last_name": "MAZZELLA",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-872-6595"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brielle, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2017; 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.