Individual provider Active NPI

Aaron J Krisik, DC

  • Chiropractor
  • Rice Lake, WI
National Provider Identifier
1760612295
Registry record updated May 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4509-012 Issued in WI
Practice address
3011 S Main St
Suite 2
Rice Lake, WI 54868-8710
Phone
(715) 234-6338
Fax
(715) 234-8364
NPI assigned
Jul 17, 2009
Last updated
May 18, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4509-012 WI Primary

Addresses

Primary practice location

3011 S Main St
Suite 2
Rice Lake, WI 54868-8710

Mailing address

3011 S Main St
Suite 2
Rice Lake, WI 54868-8710
Phone (715) 234-6338

Other identifiers 1

IdentifierTypeStateIssuer
1598136012MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090811000566 WI Practitioner - Chiropractic 8628122504 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3011 S Main St
Suite 2
Rice Lake, WI 54868-8740
Phone (715) 234-6338

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4509-012WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Owens Chiropractic LLC CurrentSince Jan 1, 2016 Accepting new patients
Krisik Chiropractic LLC CurrentSince Nov 10, 2015 Accepting new patients

Locations

3011 S Main St
Rice Lake, WI 54868
Phone (715) 234-6338

3011 S Main St
Ste 2
Rice Lake, WI 54868
Phone (715) 234-6338

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": "1247788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463529600000",
    "number": "1760612295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3011 S MAIN ST",
            "address_2": "SUITE 2",
            "city": "RICE LAKE",
            "state": "WI",
            "postal_code": "548688710",
            "telephone_number": "715-234-6338",
            "fax_number": "715-234-8364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3011 S MAIN ST",
            "address_2": "SUITE 2",
            "city": "RICE LAKE",
            "state": "WI",
            "postal_code": "548688710",
            "telephone_number": "715-234-6338",
            "fax_number": "715-234-8364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRISIK",
        "first_name": "AARON",
        "middle_name": "J",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-17",
        "last_updated": "2016-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4509-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1598136012",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rice Lake, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2016; 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.