Individual provider Active NPI

Anthony J Bawek, DC

  • Chiropractor
  • Arcadia, WI
National Provider Identifier
1235285099
Registry record updated Feb 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4282-012 Issued in WI
Practice address
305 S Dettloff Dr
Arcadia, WI 54612-1702
Phone
(608) 323-7651
Fax
(608) 323-7651
NPI assigned
Jan 26, 2007
Last updated
Feb 4, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4282-012 WI Primary

Addresses

Primary practice location

305 S Dettloff Dr
Arcadia, WI 54612-1702

Mailing address

305 S Dettloff Drive
Arcadia, WI 54612-1702
Phone (608) 323-7651

Other identifiers 2

IdentifierTypeStateIssuer
38993500OtherWIMEDICAID GROUP
38973800MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070320000598 WI Practitioner - Chiropractic 8426151028 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

305 Dettloff Dr
Arcadia, WI 54612-1702
Phone (608) 323-7651

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4282-012WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Arcadia Chiropractic & Wellness Inc. Chiropractor CurrentSince Mar 31, 2016 Accepting new patients
Scott D. Bautch D C S C Chiropractor PastSince Dec 31, 2015 Accepting new patients

Locations

305 Dettloff Dr
Arcadia, WI 54612
Phone (608) 323-7651

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454544000000",
    "number": "1235285099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 S DETTLOFF DRIVE",
            "city": "ARCADIA",
            "state": "WI",
            "postal_code": "546121702",
            "telephone_number": "608-323-7651",
            "fax_number": "608-323-7651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 S DETTLOFF DR",
            "city": "ARCADIA",
            "state": "WI",
            "postal_code": "546121702",
            "telephone_number": "608-323-7651",
            "fax_number": "608-323-7651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAWEK",
        "first_name": "ANTHONY",
        "middle_name": "J",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2016-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4282-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP",
            "identifier": "38993500",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38973800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arcadia, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2016; 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.