Individual provider Active NPI

Katy Margaret Tomczak, D.C.

  • Chiropractor
  • Racine, WI
National Provider Identifier
1841556529
Registry record updated Mar 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4877-12 Issued in WI
Practice address
3701 Durand Ave
Suite 145
Racine, WI 53405-4458
Phone
(262) 554-5458
Fax
(262) 554-7465
NPI assigned
Apr 6, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 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 4877-12 WI Primary

Addresses

Primary practice location

3701 Durand Ave
Suite 145
Racine, WI 53405-4458

Mailing address

3701 Durand Ave
Suite 145
Racine, WI 53405-4458
Phone (262) 554-5458

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120606000322 WI Practitioner - Chiropractic 4981868858 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Whitledge Family Chiropractic LLCGroup PAC ID 7517274087, 2 clinicians

Practice addresses (Care Compare)

2753 Wisconsin St
Sturtevant, WI 53177-1827
Phone (262) 886-8600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4877-12WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Whitledge Family Chiropractic LLC Chiropractor CurrentSince Feb 4, 2019 Accepting new patients

Locations

2753 Wisconsin St
Sturtevant, WI 53177
Phone (262) 886-4203

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": "1333670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425513600000",
    "number": "1841556529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 DURAND AVE",
            "address_2": "SUITE 145",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534054458",
            "telephone_number": "262-554-5458",
            "fax_number": "262-554-7465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 DURAND AVE",
            "address_2": "SUITE 145",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534054458",
            "telephone_number": "262-554-5458",
            "fax_number": "262-554-7465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMCZAK",
        "first_name": "KATY",
        "middle_name": "MARGARET",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-06",
        "last_updated": "2015-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4877-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Racine, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 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.