Individual provider Active NPI

Robert Scott Gronski, DC

  • Chiropractor
  • West Bend, WI
National Provider Identifier
1801986252
Registry record updated Jan 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2539012 Issued in WI
Practice address
223 W Paradise Dr
West Bend, WI 53095-4903
Phone
(262) 334-1011
Fax
(262) 338-0306
NPI assigned
Oct 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2539012 WI Primary

Addresses

Primary practice location

223 W Paradise Dr
West Bend, WI 53095-4903

Mailing address

223 W Paradise Dr
West Bend, WI 53095-4903
Phone (262) 334-1011

Other identifiers 1

IdentifierTypeStateIssuer
38863700MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081204000027 WI Practitioner - Chiropractic 1850452277 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

223 W Paradise Dr
West Bend, WI 53095-4903
Phone (262) 334-1011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2539012WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Falkowski Chiropractic Clinic LLC Chiropractor CurrentSince Jan 1, 2005 Accepting new patients
Kettle Moraine Chiropractic Clinic SC Chiropractor CurrentSince Apr 14, 1992 Accepting new patients

Locations

223 W Paradise Dr
West Bend, WI 53095
Phone (262) 334-1011

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422403200000",
    "number": "1801986252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 W PARADISE DR",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530954903",
            "telephone_number": "262-334-1011",
            "fax_number": "262-338-0306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 W PARADISE DR",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530954903",
            "telephone_number": "262-334-1011",
            "fax_number": "262-338-0306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRONSKI",
        "first_name": "ROBERT",
        "middle_name": "SCOTT",
        "name_prefix": "Mr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-14",
        "last_updated": "2015-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "2539012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38863700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bend, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2015; 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.