Individual provider Active NPI

James Mason Pellegrini, DC

  • Chiropractor
  • Milwaukee, WI
National Provider Identifier
1194750174
Registry record updated Aug 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1978 Issued in WI
Practice address
7929 N Port Washington Rd
Milwaukee, WI 53217
Phone
(414) 351-6766
Fax
(414) 351-6735
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1978 WI Primary

Addresses

Primary practice location

7929 N Port Washington Rd
Milwaukee, WI 53217

Mailing address

524 S Main St
West Bend, WI 53095-3936
Phone (262) 353-3733

Other identifiers 1

IdentifierTypeStateIssuer
38906500MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061208000245 WI Practitioner - Chiropractic 5395744999 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pellegrini Chiropractic LLCGroup PAC ID 6002817582, 2 clinicians

Practice addresses (Care Compare)

524 S Main St
West Bend, WI 53095-3936
Phone (262) 353-3733

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1978WIMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pellegrini Chiropractic LLC Chiropractor CurrentSince Sep 7, 2006 Accepting new patients
Brugger Chiropractic S.C. Chiropractor PastSince Oct 6, 2006 Accepting new patients

Locations

7929 N Port Washington Rd
Glendale, WI 53217
Phone (414) 351-6766

524 S Main St
West Bend, WI 53095
Phone (262) 353-3733

Organizations & group practices 2

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597017600000",
    "number": "1194750174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "524 S MAIN ST",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530953936",
            "telephone_number": "262-353-3733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7929 N PORT WASHINGTON RD",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53217",
            "telephone_number": "414-351-6766",
            "fax_number": "414-351-6735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLEGRINI",
        "first_name": "JAMES",
        "middle_name": "MASON",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2020-08-10",
        "certification_date": "2020-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "1978",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38906500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2020; 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.