Executive Spine Surgery PC
NPI 1164789582ActiveOrganization· Neurological Surgery· Newton, NJ
Neurological Surgery in Newton, New Jersey, registered in NPPES in April 2012. The authorized official on file is Irina Kamenetskiy, Adminitrator. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1164789582 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Apr 23, 2012 |
| Last updated in NPPES | Feb 9, 2021 |
| Certified by provider | Feb 9, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Neurological Surgery Primary | 207T00000X | 25MA09005200 | NJ |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (NJ) |
|---|
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