Organization Active NPI

Elite Male T Clinic, LLC Dba Elite Hormones

  • Integrative Medicine Physician
  • Wausau, WI
National Provider Identifier
1629916192
Registry record updated Mar 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Integrative Medicine PhysicianTaxonomy code 202D00000X
Legal business name
ELITE MALE T CLINIC, LLC DBA ELITE HORMONES
Practice address
505 S 24TH Ave Ste 204
Wausau, WI 54401-1706
Phone
(715) 240-4150
NPI assigned
Mar 24, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2026

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

Authorized official

Name
Anne Ivaska, APNPNPI 1801147293
Title
Owner
Phone
(715) 370-0380

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Integrative Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 202D00000X Primary

Addresses

Primary practice location

505 S 24TH Ave Ste 204
Wausau, WI 54401-1706

Mailing address

3164 Shady LN
Stevens Point, WI 54481-9508
Phone (715) 370-0380

Other practice location 1

2633 N Clairemont Ave
Eau Claire, WI 54703-2405
Phone (715) 240-4150

Other practice location 2

7704 Terrace Ave Ste 1
Middleton, WI 53562-3122
Phone (715) 240-4150

National Provider Directory

National Provider Directory

Locations

2633 N Clairemont Ave
Eau Claire, WI 54703
Phone 7152404150 ext. 00380

7704 Terrace Ave
Ste 1
Middleton, WI 53562
Phone 7152404150 ext. 00380

505 S 24th Ave
Ste 204
Wausau, WI 54401
Phone (715) 240-4150

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1774310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774310400000",
    "number": "1629916192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3164 SHADY LN",
            "city": "STEVENS POINT",
            "state": "WI",
            "postal_code": "544819508",
            "telephone_number": "715-370-0380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 S 24TH AVE STE 204",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544011706",
            "telephone_number": "715-240-4150"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2633 N Clairemont Ave",
            "address_purpose": "LOCATION",
            "city": "Eau Claire",
            "state": "WI",
            "postal_code": "547032405",
            "country_code": "US",
            "telephone_number": "715-240-4150",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7704 Terrace Ave Ste 1",
            "address_purpose": "LOCATION",
            "city": "Middleton",
            "state": "WI",
            "postal_code": "535623122",
            "country_code": "US",
            "telephone_number": "715-240-4150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ELITE MALE T CLINIC, LLC DBA ELITE HORMONES",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-24",
        "last_updated": "2026-03-24",
        "certification_date": "2026-03-24",
        "status": "A",
        "authorized_official_last_name": "IVASKA",
        "authorized_official_first_name": "ANNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "715-370-0380",
        "authorized_official_credential": "APNP"
    },
    "taxonomies": [
        {
            "code": "202D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Integrative Medicine",
            "state": null,
            "license": null,
            "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 Mar 24, 2026; 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.