Individual provider Active NPI

Matthew R Gajkowski, D.C., D.A.C.R.B.

  • Chiropractor
  • Akron, OH
National Provider Identifier
1972648525
Registry record updated Jul 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1738 Issued in OH
Practice address
1458 Copley Road
Akron, OH 44685-2654
Phone
(330) 836-8661
Fax
(330) 836-8757
NPI assigned
Feb 21, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1738 OH Primary
Rehabilitation Chiropractor 111NR0400X 1738 OH
Acupuncturist 171100000X 10 OH

Addresses

Primary practice location

1458 Copley Road
Akron, OH 44685-2654

Mailing address

1458 Copley Road
Akron, OH 44320-2654
Phone (330) 836-8661

Other identifiers 2

IdentifierTypeStateIssuer
0225509MedicaidOH
4698900001OtherDMERC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111122000693 OH Practitioner - ChiropracticPractitioner - Other (Physician) 2668687955 Receives reassigned benefits from 1 practitioner
Practice locations: Akron, OH

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1458 Copley Rd
Akron, OH 44320-2654
Phone (330) 836-8661

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10OHMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Cooperative Medical Health Care Corporation Professional Association Chiropractor PastSince Oct 1, 2004 Accepting new patients

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Organizations & group practices 1

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": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311206400000",
    "number": "1972648525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1458 COPLEY ROAD",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443202654",
            "telephone_number": "330-836-8661",
            "fax_number": "330-836-8757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1458 COPLEY ROAD",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "446852654",
            "telephone_number": "330-836-8661",
            "fax_number": "330-836-8757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAJKOWSKI",
        "first_name": "MATTHEW",
        "middle_name": "R",
        "credential": "D.C., D.A.C.R.B.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2011-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "1738",
            "primary": true
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "OH",
            "license": "1738",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OH",
            "license": "10",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0225509",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "4698900001",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Akron, OH

Sources for this page

Verify at the official NPI Registry.