Individual provider Active NPI

Matthew Bautch, DC

  • Chiropractor
  • Wausau, WI
National Provider Identifier
1508338559
Registry record updated Dec 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5427 Issued in WI
Practice address
3540 Stewart Ave
Wausau, WI 54401-4919
Phone
(715) 842-3999
Fax
(715) 843-7761
NPI assigned
Dec 31, 2018
Last updated
Dec 31, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5427 WI Primary

Addresses

Primary practice location

3540 Stewart Ave
Wausau, WI 54401-4919

Mailing address

3540 Stewart Ave
Wausau, WI 54401-4919
Phone (715) 842-3999

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190207000801 WI Practitioner - Chiropractic 6305184870 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scott D Bautch DC SCGroup PAC ID 7214237759, 5 clinicians

Practice addresses (Care Compare)

1915 N 6TH St
Wausau, WI 54403-3435
Phone (715) 842-3999

3540 Stewart Ave
Wausau, WI 54401-4919

3540 Stewart Ave a
Wausau, WI 54401-4919

515 S 32ND Ave
Wausau, WI 54401-4919
Phone (715) 842-3999

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Allied Health of Wisconsin, SC Chiropractor PastSince Sep 30, 1994 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1546214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546214400000",
    "number": "1508338559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3540 STEWART AVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014919",
            "telephone_number": "715-842-3999",
            "fax_number": "715-843-7761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3540 STEWART AVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014919",
            "telephone_number": "715-842-3999",
            "fax_number": "715-843-7761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUTCH",
        "first_name": "MATTHEW",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-31",
        "last_updated": "2018-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "5427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2018; 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.