Midwest Sports and Interventional Spine SC

A Medicare group practice based in Kenosha, WI: 2 NPIs enrolled under one PECOS associate control ID (PAC ID 8325447170), with 5 clinicians.

Medicare enrollment

Medicare enrollment files
PAC ID
8325447170The PECOS associate control ID: one enrolled organization, which may hold several NPIs
Provider type
DME Supplier - Multi-Specialty - Physician, DME Supplier - Physician - Anesthesiology, Part B Supplier - Clinic/Group Practice
Enrolled in
WI
Enrollments
3
Group size
5 cliniciansAs Care Compare reports it
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Practice locations
4In 2 places

Enrollment records 3

Enrollment IDStateProvider typeNPI
O20210527000135 WI Part B Supplier - Clinic/Group Practice 1831770510
O20250516001770 WI DME Supplier - Physician - Anesthesiology 1831770510
O20251219003999 WI DME Supplier - Multi-Specialty - Physician 1740154947

NPIs in this group 2

NPPES NPI Registry

These NPI records belong to the same enrolled organization. Each has its own page.

Practice locations

Locations on the Medicare enrollment

Clinicians 5

Clinicians who reassign their Medicare benefits to this group (5) or whom Care Compare lists as members (5).

Sources for this page