Individual provider Active NPI

Steven Robert Puckette, DC

  • Neurology Chiropractor
  • Madison, WI
National Provider Identifier
1811905565
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology ChiropractorTaxonomy code 111NN0400X
License
3198012 Issued in WI
Practice address
8517 Excelsior Dr Ste 300
Madison, WI 53717-2910
Phone
(608) 276-7635
Fax
(608) 276-7728
NPI assigned
Aug 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Chiropractor 111NN0400X 3198012 WI Primary

Addresses

Primary practice location

8517 Excelsior Dr Ste 300
Madison, WI 53717-2910

Mailing address

822 E Washington Ave Apt 730
Madison, WI 53703-6508
Phone (608) 698-3149

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130528000239 WI Practitioner - Chiropractic 9830337104 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1994
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

8517 Excelsior Dr
Suite 300
Madison, WI 53717-2910
Phone (608) 276-7635

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3198012WIMDNeurology Chiropractor

Organizations & group practices 1

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": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1811905565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "822 E WASHINGTON AVE APT 730",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537036508",
            "telephone_number": "608-698-3149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8517 EXCELSIOR DR STE 300",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537172910",
            "telephone_number": "608-276-7635",
            "fax_number": "608-276-7728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUCKETTE",
        "first_name": "STEVEN",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "WI",
            "license": "3198012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; 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.