Individual provider Active NPI

Minjae Yoo

  • Chiropractor
  • Fort Lee, NJ
National Provider Identifier
1972048346
Registry record updated Dec 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X012790 Issued in NY
Practice address
1209 15TH St FL 1
Fort Lee, NJ 07024-1707
Phone
(551) 655-4284
NPI assigned
Dec 21, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X012790 NY Primary

Addresses

Primary practice location

1209 15TH St FL 1
Fort Lee, NJ 07024-1707

Mailing address

1209 15TH Street 1St Floor
Fortlee, NJ 07024
Phone (551) 655-4284

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X012790NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Zenhealth Acupuncture PC CurrentSince Nov 24, 2024 Accepting new patients
Upright Chiropractic PC Chiropractor Current Accepting new patients

Locations

158 Linwood Plz
Ste 307
Fort Lee, NJ 07024
Phone (201) 566-5396

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1482278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482278400000",
    "number": "1972048346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1209 15TH STREET 1ST FLOOR",
            "city": "FORTLEE",
            "state": "NJ",
            "postal_code": "07024",
            "telephone_number": "551-655-4284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1209 15TH ST FL 1",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070241707",
            "telephone_number": "551-655-4284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOO",
        "first_name": "MINJAE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-12-21",
        "last_updated": "2016-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X012790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lee, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.