Individual provider Active NPI

Andrea Benko, D.C.

  • Chiropractor
  • Branford, CT
National Provider Identifier
1174767768
Registry record updated Feb 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
001519 Issued in CT
Practice address
400 West Main Street
Branford, CT 06405
Phone
(203) 483-7778
Fax
(203) 481-0234
NPI assigned
Apr 27, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 001519 CT Primary

Addresses

Primary practice location

400 West Main Street
Branford, CT 06405

Mailing address

400 West Main Street
Branford, CT 06405
Phone (203) 483-7778

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220924000272 WI Practitioner - Chiropractic 4789813007 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Koch Chiropractic and Wellness CenterGroup PAC ID 8921004011, 4 clinicians

Practice addresses (Care Compare)

815 W Fulton St
Suite 6
Waupaca, WI 54981-1405
Phone (715) 256-9616

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001519CTMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Koch Chiropractic and Wellness Center Chiropractor CurrentSince Aug 31, 2022 Accepting new patients

Locations

815 W Fulton St
Ste 6
Waupaca, WI 54981
Phone (715) 256-9616

1990 Godfrey Dr
Waupaca, WI 54981
Phone (715) 256-9616

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": "1240790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266969600000",
    "number": "1174767768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 WEST MAIN STREET",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "06405",
            "telephone_number": "203-483-7778",
            "fax_number": "203-481-0234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 WEST MAIN STREET",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "06405",
            "telephone_number": "203-483-7778",
            "fax_number": "203-481-0234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENKO",
        "first_name": "ANDREA",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-27",
        "last_updated": "2010-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CT",
            "license": "001519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Branford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2010; 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.