Individual provider Active NPI

Daniel Joseph Eoriatti, D.C.

  • Chiropractor
  • Black River Falls, WI
National Provider Identifier
1386789246
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3409-012 Issued in WI
Practice address
438 N Water St
Black River Falls, WI 54615-1005
Phone
(715) 284-5551
Fax
(715) 284-9164
NPI assigned
Feb 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3409-012 WI Primary

Addresses

Primary practice location

438 N Water St
Black River Falls, WI 54615-1005

Mailing address

438 N Water St
Black River Falls, WI 54615-1005
Phone (715) 284-5551

Other identifiers 2

IdentifierTypeStateIssuer
38992500MedicaidWI
38930300MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050426000181 WI Practitioner - Chiropractic 9335188838 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

Practice addresses (Care Compare)

640 Commerce St
Suite a
West Salem, WI 54669-1180
Phone (608) 786-3304

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3409-012WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
West Salem Chiropractic Clinic, Inc. CurrentSince Jan 1, 2005 Accepting new patients
Jessen Family Chiropractic Clinic Inc Chiropractor PastSince Feb 24, 1997 Accepting new patients

Locations

640 Commerce St
West Salem, WI 54669
Phone (608) 786-3304

640 Commerce St
Ste A
West Salem, WI 54669
Phone (608) 786-3304

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.

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1386789246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "438 N WATER ST",
            "city": "BLACK RIVER FALLS",
            "state": "WI",
            "postal_code": "546151005",
            "telephone_number": "715-284-5551",
            "fax_number": "715-284-9164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "438 N WATER ST",
            "city": "BLACK RIVER FALLS",
            "state": "WI",
            "postal_code": "546151005",
            "telephone_number": "715-284-5551",
            "fax_number": "715-284-9164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EORIATTI",
        "first_name": "DANIEL",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-20",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3409-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38992500",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38930300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Black River Falls, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.