Christabelle E Braaksma, D.D.S

Primary specialty

DentistTaxonomy code 122300000X

License

1001037 Issued in WI

Practice address

2202 S Park St
Madison, WI 53713-1916

Phone

(608) 443-5482

Fax

(608) 443-5534

NPI assigned

Jul 23, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Christabelle Mitchell Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Sep 25, 2017 through Sep 25, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: cbraaksma1058930@direct.uwhealth.org

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.

• La Clinica de Los Campesinos, Inc

  • Federally Qualified Health Center (FQHC)
  • Stevens Point, WI
  • NPI 1790786929

  Dentist

  NPD (past)

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

{
    "created_epoch": "1374537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620086400000",
    "number": "1669814455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7974 UW HEALTH CT",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535625531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2202 S PARK ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537131916",
            "telephone_number": "608-443-5482",
            "fax_number": "608-443-5534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAAKSMA",
        "first_name": "CHRISTABELLE",
        "middle_name": "E",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-23",
        "last_updated": "2021-05-04",
        "certification_date": "2021-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019029549",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "1001037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cbraaksma1058930@direct.uwhealth.org",
            "affiliation": "N",
            "address_1": "2202 S Park St",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537131916",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CHRISTABELLE",
            "last_name": "MITCHELL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nicole Boyle
• Robert W Boyle, MD
• John David Boyne, MA,LPC,SACIT
• Polly B Boynton, APNP
• Margaret Bozdech
• Peggy Braam, MS, LPC
• Melody Braaten
• Ellen P Braatz, P.T.
• William Haendel Bracamonte Baran, MD, PHD
• Calvin James Brace, SAC-IT

• All providers in Madison, WI
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.