Individual provider Active NPI

Martin Joepeck, D.C.

  • Chiropractor
  • West Allis, WI
National Provider Identifier
1154456770
Registry record updated Feb 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3789-012 Issued in WI
Practice address
3044 S 92ND St
West Allis, WI 53227-3678
Phone
(414) 545-5433
Fax
(414) 545-6757
NPI assigned
Feb 22, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 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 3789-012 WI Primary

Addresses

Primary practice location

3044 S 92ND St
West Allis, WI 53227-3678

Mailing address

1101 S 86TH St
West Allis, WI 53214-2969
Phone (414) 517-6487

Other identifiers 1

IdentifierTypeStateIssuer
38933400MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080418000429 WI Practitioner - Chiropractic 5698853489 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3044 S 92ND St
West Allis, WI 53227-3678
Phone (414) 545-5433

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3789-012WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Ultimate Life Chiropractic Inc. Chiropractor CurrentSince Jan 19, 2008 Accepting new patients

Locations

3044 S 92nd St
West Allis, WI 53227
Phone (414) 321-7744

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": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202342400000",
    "number": "1154456770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 S 86TH ST",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532142969",
            "telephone_number": "414-517-6487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3044 S 92ND ST",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532273678",
            "telephone_number": "414-545-5433",
            "fax_number": "414-545-6757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOEPECK",
        "first_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2008-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3789-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38933400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Allis, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 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.