Active NPI
Joshua Jerome Tyjeski, D.C.
- Chiropractor
- Beaver Dam, WI
National Provider Identifier
1336685643
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 5239-12
- Practice address
- 119 E Mackie St
Beaver Dam, WI 53916-2031 - Phone
- (920) 885-3020
- NPI assigned
- Jan 10, 2017
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 5239-12 | WI | Primary |
Addresses
Primary practice location
119 E Mackie St
Beaver Dam, WI 53916-2031
Mailing address
119 E Mackie St
Beaver Dam, WI 53916-2031
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5239-12 | WI | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tyjeski Family Chiropractic | Chiropractor | Current | Accepting new patients |
Locations
119 E Mackie St
Beaver Dam, WI 53916
Phone (920) 885-3020
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.
-
- Chiropractor
- Beaver Dam, WI
- NPI 1104993658
-
- Chiropractor
- Beaver Dam, WI
- NPI 1396418083
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1484006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656288000000",
"number": "1336685643",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "119 E MACKIE ST",
"city": "BEAVER DAM",
"state": "WI",
"postal_code": "539162031"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "119 E MACKIE ST",
"city": "BEAVER DAM",
"state": "WI",
"postal_code": "539162031",
"telephone_number": "920-885-3020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TYJESKI",
"first_name": "JOSHUA",
"middle_name": "JEROME",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-01-10",
"last_updated": "2022-06-27",
"certification_date": "2022-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WI",
"license": "5239-12",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beaver Dam, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.