Christopher Bragagnolo, MD
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Elkhorn, WI
NPI 1508552811 · NPPES record last updated May 15, 2023
Key facts
- NPI
- 1508552811
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- W3985 County Road NN
Elkhorn, WI 53121-4337 - Phone
- (262) 741-2121
- Fax
- (262) 741-2178
- NPI assigned
- Apr 11, 2023
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250501001620 | WI | Order and Referring Only - Family Practice |
5092231167 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
W3985 County Road NN
Elkhorn, WI 53121-4337
Mailing address
177 Amherst Cir
Oswego, IL 60543-5203
Phone (630) 308-5650
Other providers in Elkhorn, WI
- Chetney Marie Blaszczyk
- Katelyn Blatter
- James E. Bodoh
- Desiree Amber Bonngard
- Jaymie Ann Braden
- Mary Brauer
- Kelly L Brazer
- Mary Breese
- Karen Breit
- Ronna Lynette Brennan
All providers in Elkhorn, WI · Student in an Organized Health Care Education/Training Program in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 15, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.