Christopher J Bacsik, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

5448-015 Issued in WI

Practice address

5801 Research Park Blvd
Ste 110
Madison, WI 53719-6002

Phone

(608) 274-0770

Fax

(608) 274-9224

NPI assigned

Jun 23, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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 Apr 13, 2015 through Apr 13, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• The Medical College of Wisconsin, Inc.

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1699720086
  NPD (past)

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1740216712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1306 RED TAIL DR",
            "city": "VERONA",
            "state": "WI",
            "postal_code": "535937964",
            "telephone_number": "608-848-0510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5801 RESEARCH PARK BLVD",
            "address_2": "STE 110",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537196002",
            "telephone_number": "608-274-0770",
            "fax_number": "608-274-9224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACSIK",
        "first_name": "CHRISTOPHER",
        "middle_name": "J",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WI",
            "license": "5448-015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33738600",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEAN HEALTH PLAN ID#",
            "identifier": "13127",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Back & Neck Wellness Center Inc.
• Emily Backes, MD
• Katelyn Marie Backhaus, MD
• Michelle N. Backs, OTR
• Taylor Bacon
• Piper Hartt Bacskai, OTR/L
• Amr Badawi, M.D.
• Alanna J Bade, PA
• Amanda Bade
• Rory Michael Bade

• All providers in Madison, WI
• Oral and Maxillofacial Surgery (Dentist) in Wisconsin

• 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; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.