Individual provider Active NPI

Andrew C Stopczynski, DC

  • Chiropractor
  • West Bend, WI
National Provider Identifier
1083774152
Registry record updated Oct 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3495-012 Issued in WI
Practice address
1624 Clarence CT
West Bend, WI 53095-8533
Phone
(262) 334-4847
Fax
(262) 334-5554
NPI assigned
Dec 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3495-012 WI Primary

Addresses

Primary practice location

1624 Clarence CT
West Bend, WI 53095-8533

Mailing address

1624 Clarence CT
West Bend, WI 53095-8533
Phone (262) 334-4847

Other identifiers 1

IdentifierTypeStateIssuer
38946700MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040701000405 WI Practitioner - Chiropractic 0042297780 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3495-012WIMDChiropractor
3495WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Motus Chiropractic & Spine Rehab SC CurrentSince Sep 26, 2023 Accepting new patients
Brugger Chiropractic S.C. Chiropractor CurrentSince May 20, 2008 Accepting new patients
Intergrated Pain and Spine Care SC Past Accepting new patients
Columbia St. Mary'S Hospital Milwaukee, Inc Past Accepting new patients
Chiropractic Company S.C. Chiropractor Past Accepting new patients

Locations

5261 N Port Washington Rd
Ste 101
Glendale, WI 53217
Phone (414) 332-6001

1524 S Green Bay Rd
Ste 103
Mount Pleasant, WI 53406
Phone (262) 884-7580

1624 Clarence Ct
West Bend, WI 53095
Phone (262) 334-4847

Organizations & group practices 6

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": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318550400000",
    "number": "1083774152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1624 CLARENCE CT",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530958533",
            "telephone_number": "262-334-4847",
            "fax_number": "262-334-5554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1624 CLARENCE CT",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530958533",
            "telephone_number": "262-334-4847",
            "fax_number": "262-334-5554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOPCZYNSKI",
        "first_name": "ANDREW",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2011-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3495-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38946700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bend, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2011; 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.