Individual provider Active NPI

Michael Vajda, D.C.

  • Chiropractor
  • Middletown, CT
National Provider Identifier
1982623955
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
649 Issued in CT
Practice address
761 Washington St
Middletown, CT 06457-2903
Phone
(860) 343-0222
Fax
(860) 343-1544
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 649 CT Primary

Addresses

Primary practice location

761 Washington St
Middletown, CT 06457-2903

Mailing address

761 Washington St
Middletown, CT 06457-2903
Phone (860) 343-0222

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110419000024 CT Practitioner - Chiropractic 5799969671 Reassigns benefits to 1 organization

Care Compare profile

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

Practice addresses (Care Compare)

761 Washington St
Middletown, CT 06457-2903
Phone (860) 343-0222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00649CTMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Michael Vajda, D.C., L.L.C. Chiropractor CurrentSince Jan 16, 2011 Accepting new patients

Locations

761 Washington St
Middletown, CT 06457
Phone (860) 343-0222

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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982623955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "761 WASHINGTON ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064572903",
            "telephone_number": "860-343-0222",
            "fax_number": "860-343-1544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "761 WASHINGTON ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064572903",
            "telephone_number": "860-343-0222",
            "fax_number": "860-343-1544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAJDA",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CT",
            "license": "649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.