Individual provider Active NPI

Paul Matthew Piergentile, D.C.

  • Chiropractor
  • Franklin Lakes, NJ
National Provider Identifier
1982754362
Registry record updated Aug 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X010800 Issued in NY
Practice address
807 Franklin Ave
Franklin Lakes, NJ 07417-1372
Phone
(201) 891-5599
Fax
(201) 891-8404
NPI assigned
Jan 10, 2007
Last updated
Aug 16, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X010800 NY Primary

Addresses

Primary practice location

807 Franklin Ave
Franklin Lakes, NJ 07417-1372

Mailing address

15 9TH Ave
Hawthorne, NJ 07506-1710
Phone (914) 806-5802

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081023000066 NJ Practitioner - Chiropractic 1951405703 Practice locations: Franklin Lakes, NJ

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X010800NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Family & Sports Injury Center Chiropractor Past Accepting new patients
Advanced Sports PT One LLC PastSince Oct 9, 2023 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281916800000",
    "number": "1982754362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 9TH AVE",
            "city": "HAWTHORNE",
            "state": "NJ",
            "postal_code": "075061710",
            "telephone_number": "914-806-5802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807 FRANKLIN AVE",
            "city": "FRANKLIN LAKES",
            "state": "NJ",
            "postal_code": "074171372",
            "telephone_number": "201-891-5599",
            "fax_number": "201-891-8404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIERGENTILE",
        "first_name": "PAUL",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2010-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X010800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Franklin Lakes, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2010; 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.