Individual provider Active NPI

Jack Melvin Masche, D.C.

  • Chiropractor
  • Milwaukee, WI
National Provider Identifier
1205913530
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1764012 Issued in WI
Practice address
5055 S 110TH St
Milwaukee, WI 53228-3131
Phone
(414) 529-5370
Fax
(414) 529-5376
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1764012 WI Primary

Addresses

Primary practice location

5055 S 110TH St
Milwaukee, WI 53228-3131

Mailing address

5055 S 110TH St
Milwaukee, WI 53228-3131
Phone (414) 529-5370

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120308000835 WI Practitioner - ChiropracticPractitioner - Physical Medicine and Rehabilitation 7810156916 Practice locations: Greenfield, WI

Care Compare profile

Medicare Care Compare
Specialty
ChiropracticAlso: Physical Medicine and Rehabilitation
Education
Palmer College Chiropractic - Davenport, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5055 S 110TH St
Greenfield, WI 53228-3131
Phone (414) 529-5370

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1764012WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Masche Chiropractic Wellness Center Chiropractor PastSince Jan 1, 1966 Accepting new patients

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205913530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5055 S 110TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532283131",
            "telephone_number": "414-529-5370",
            "fax_number": "414-529-5376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5055 S 110TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532283131",
            "telephone_number": "414-529-5370",
            "fax_number": "414-529-5376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASCHE",
        "first_name": "JACK",
        "middle_name": "MELVIN",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "1764012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.