Dale John Krumrai, B.S., D.C.
Individual provider Active NPI Chiropractor · Pulaski, WI
NPI 1871662874 · NPPES record last updated Dec 22, 2012
Key facts
- NPI
- 1871662874
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 2449012 (WI)
- Practice address
- 415 S Wisconsin Ave
Pulaski, WI 54162-0143 - Phone
- (920) 822-5441
- Fax
- (920) 822-1635
- NPI assigned
- Nov 6, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- National College of Chiropractic, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
415 S Wisconsin Ave
Pulaski, WI 54162-0143
Phone (920) 822-5441
415 S Wisconsin Ave PO Box
Suite 143
Pulaski, WI 54162-0143
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110224000288 | WI | Practitioner - Chiropractic | 9739360751 | Practice locations: Pulaski, WI |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2449012 | WI | MD | Chiropractor |
| 2449 | WI | MD | Emergency Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2449012 | WI | Yes |
Addresses
Primary practice location
415 S Wisconsin Ave
Pulaski, WI 54162-0143
Mailing address
415 S Wisconsin Ave
P.O. Box 143
Pulaski, WI 54162-0143
Phone (920) 822-5441
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 38841700 | Medicaid | WI |
Other providers in Pulaski, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 22, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.