Active NPI
Brayden Lee Krivachek
- Student in an Organized Health Care Education/Training Program
- West Des Moines, IA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 8025 Grand Ave
West Des Moines, IA 50266-5360 - Phone
- (515) 271-1569
- NPI assigned
- Mar 31, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
8025 Grand Ave
West Des Moines, IA 50266-5360
Mailing address
805 US Highway 52
Decorah, IA 52101-9303
Phone (563) 277-2667
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI, MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
12375 Lindstrom LN
Lindstrom, MN 55045-9551
Phone (651) 400-2240
235 E State St
Saint Croix Falls, WI 54024-4117
Phone (715) 483-3221
Hospital & facility affiliations
- St Croix Regional Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15516 | MN | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Croix Regional Medical Center | Current | Accepting new patients | |
| St. Croix Regional Medical Center | Current | Accepting new patients |
Locations
1504 190th Ave
Balsam Lake, WI 54810
Phone (715) 825-3278
205 Oak St W
Frederic, WI 54837
Phone (715) 327-5700
216 S Adams St
St Croix Fls, WI 54024
Phone (715) 483-0426
235 E State St
St Croix Fls, WI 54024
Phone (715) 483-3221
26425 Lakeland Ave S
Webster, WI 54893
Phone (715) 866-4271
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.
-
- Rural Health Clinic/Center
- Balsam Lake, WI
- NPI 1013423219
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Saint Croix Falls, WI
- NPI 1043240922
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1743379200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1743379200000",
"number": "1245033760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "805 US HIGHWAY 52",
"city": "DECORAH",
"state": "IA",
"postal_code": "521019303",
"telephone_number": "563-277-2667"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8025 GRAND AVE",
"city": "WEST DES MOINES",
"state": "IA",
"postal_code": "502665360",
"telephone_number": "515-271-1569"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRIVACHEK",
"first_name": "BRAYDEN",
"middle_name": "LEE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-03-31",
"last_updated": "2025-03-31",
"certification_date": "2025-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in West Des Moines, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.