Individual provider Active NPI

Mark Christopher Nemetz, D.C.

  • Chiropractor
  • Brookfield, WI
National Provider Identifier
1770525958
Registry record updated Dec 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3397-012 Issued in WI
Practice address
17550 W Bluemound Rd
Suite 210
Brookfield, WI 53045-2928
Phone
(262) 782-2273
Fax
(262) 782-6946
NPI assigned
Jun 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3397-012 WI Primary

Addresses

Primary practice location

17550 W Bluemound Rd
Suite 210
Brookfield, WI 53045-2928

Mailing address

17550 W Bluemound Rd
Suite 210
Brookfield, WI 53045-2928
Phone (262) 782-2273

Other identifiers 2

IdentifierTypeStateIssuer
38950000MedicaidWI
604939200OtherWORK COMP

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address mnemetz32043@direct.myadvocateaurora.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040430000281 WI Practitioner - Chiropractic 5193712099 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3397-012WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Health Care Metro, Inc. CurrentSince Feb 6, 2019 Accepting new patients
Aurora Advanced Healthcare, Inc. CurrentSince Jul 17, 2014 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jul 14, 2014 Accepting new patients
Aurora Advanced Healthcare Inc CurrentSince Jul 17, 2014 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jul 14, 2014 Accepting new patients
Aurora Health Care Metro, Inc. CurrentSince Feb 6, 2019 Accepting new patients
Chiropractic Company S.C. Chiropractor Past Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients
M. Casey Chiro-Care LLC Chiropractor PastSince Nov 19, 2004 Accepting new patients
Westwood Chiropractic Chiropractor Past Accepting new patients

Locations

3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100

12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200

1020 N 12th St
Fl 4
Milwaukee, WI 53233
Phone (414) 219-5000

3305 S 20th St
Milwaukee, WI 53215
Phone (414) 384-2100

2900 W Oklahoma Ave
Milwaukee, WI 53215
Phone (414) 385-2590

3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

205 Valley Ave
West Bend, WI 53095
Phone (262) 338-1123

Interoperability endpoints

  • Direct secure messaging: mnemetz32043@direct.myadvocateaurora.org

Organizations & group practices 10

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.

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc. 3,764 clinicians

Practice addresses (Care Compare)

1020 N 12TH St
Milwaukee, WI 53233-1308
Phone (414) 219-3056

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639094400000",
    "number": "1770525958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17550 W BLUEMOUND RD",
            "address_2": "SUITE 210",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530452928",
            "telephone_number": "262-782-2273",
            "fax_number": "262-782-6946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17550 W BLUEMOUND RD",
            "address_2": "SUITE 210",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530452928",
            "telephone_number": "262-782-2273",
            "fax_number": "262-782-6946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEMETZ",
        "first_name": "MARK",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2021-12-10",
        "certification_date": "2021-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3397-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38950000",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORK COMP",
            "identifier": "604939200",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "17550 W Bluemound Rd",
            "address_2": "Suite 210",
            "city": "Brookfield",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530452928",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mnemetz32043@direct.myadvocateaurora.org",
            "affiliation": "N",
            "address_1": "17550 W Bluemound Rd",
            "address_2": "Suite 210",
            "city": "Brookfield",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530452928",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brookfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2021; 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.