Individual provider Active NPI

Richard Todd Kirstein, D.C.

  • Chiropractor
  • Vineland, NJ
National Provider Identifier
1992799373
Registry record updated Apr 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
MC 02778 Issued in NJ
Practice address
630 S Brewster Rd
Vineland, NJ 08361-7801
Phone
(856) 692-9299
Fax
(856) 696-3870
NPI assigned
Aug 31, 2005
Reactivated
Mar 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X MC 02778 NJ Primary

Addresses

Primary practice location

630 S Brewster Rd
Vineland, NJ 08361-7801

Mailing address

630 S Brewster Rd
Unit B2
Vineland, NJ 08361-7801
Phone (856) 692-9299

Other identifiers 1

IdentifierTypeStateIssuer
1303902MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080319000466 NJ Practitioner - Chiropractic 5597841312 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1984
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

630 S Brewster Rd
Vineland, NJ 08361-7801
Phone (856) 692-9299

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MC 02778NJMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Kirstein Chiropractic LLC Chiropractor CurrentSince Jan 1, 2008 Accepting new patients

Locations

630 S Brewster Rd
Ste B2
Vineland, NJ 08361
Phone (856) 692-9299

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": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207699200000",
    "number": "1992799373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 S BREWSTER RD",
            "address_2": "UNIT B2",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083617801",
            "telephone_number": "856-692-9299",
            "fax_number": "856-696-3870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 S BREWSTER RD",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083617801",
            "telephone_number": "856-692-9299",
            "fax_number": "856-696-3870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRSTEIN",
        "first_name": "RICHARD",
        "middle_name": "TODD",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-31",
        "last_updated": "2008-04-09",
        "deactivation_date": "2006-03-24",
        "reactivation_date": "2006-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "MC 02778",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1303902",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vineland, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2008; 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.