Bruce S. Bencriscutto, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1636-012 Issued in WI

Practice address

612 N Church St
Watertown, WI 53098-2111

Phone

(920) 261-1226

Fax

(920) 261-1435

NPI assigned

Oct 18, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Luedtke-Storm-Mackey Chiropractic Clinic SC

  • Chiropractor
  • Sun Prairie, WI
  • NPI 1457343246
  NPD (past)
• Petersen Chiropractic Office, S.C.

  • Chiropractor
  • Watertown, WI
  • NPI 1841368941
  NPD (past)

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316028707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 N CHURCH ST",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530982111",
            "telephone_number": "920-261-1226",
            "fax_number": "920-261-1435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 N CHURCH ST",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530982111",
            "telephone_number": "920-261-1226",
            "fax_number": "920-261-1435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENCRISCUTTO",
        "first_name": "BRUCE",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "1636-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WPS",
            "identifier": "75609",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEAN CARE HMO",
            "identifier": "525007",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brittany Batten, PTA
• Elizabeth Sarah Baumann, DDS
• Erik Dmitri Beaver, PH.D.
• Wendy M Becker, RN
• Bedrock HCS at Watertown LLC
• Cynthia Ann Bennett, LPN
• Kristine Elizabeth Bennett, RDN,CD
• Leah Marie Benz, LPC
• Bethel Counseling & Consultation LLC
• Bethesda Lutheran Communities

• Chiropractor in Watertown, WI
• Providers in Watertown, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.