Individual provider Active NPI

Todd M Tesch, DC

  • Chiropractor
  • Fort Atkinson, WI
National Provider Identifier
1295727055
Registry record updated Jun 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3481 Issued in WI
Practice address
1000 Madison Ave
Fort Atkinson, WI 53538-1326
Phone
(920) 563-4970
Fax
(920) 563-8877
NPI assigned
Aug 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3481 WI Primary

Addresses

Primary practice location

1000 Madison Ave
Fort Atkinson, WI 53538-1326

Mailing address

105 Clarmar Dr
Sun Prairie, WI 53590-2675
Phone (608) 318-5929

Other identifiers 1

IdentifierTypeStateIssuer
38904800MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041124000514 WI Practitioner - Chiropractic 4981669355 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Luedtke-Storm-Mackey Chiropractic Clinic, SCGroup PAC ID 6204737240, 33 clinicians

Practice addresses (Care Compare)

1000 Madison Ave
Fort Atkinson, WI 53538-1326
Phone (920) 563-4970

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3481WIMDNurse Practitioner

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": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719446400000",
    "number": "1295727055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 CLARMAR DR",
            "city": "SUN PRAIRIE",
            "state": "WI",
            "postal_code": "535902675",
            "telephone_number": "608-318-5929",
            "fax_number": "608-318-5922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MADISON AVE",
            "city": "FORT ATKINSON",
            "state": "WI",
            "postal_code": "535381326",
            "telephone_number": "920-563-4970",
            "fax_number": "920-563-8877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TESCH",
        "first_name": "TODD",
        "middle_name": "M",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38904800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Atkinson, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2024; 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.