Individual provider Active NPI

Paul Robert Krzesinski, D.C.

  • Chiropractor
  • Elkhorn, WI
National Provider Identifier
1932379062
Registry record updated Feb 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4432-12 Issued in WI
Practice address
422 N Wisconsin St
Suite a
Elkhorn, WI 53121-1318
Phone
(262) 723-3235
Fax
(262) 723-8621
NPI assigned
Mar 4, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4432-12 WI Primary

Addresses

Primary practice location

422 N Wisconsin St
Suite a
Elkhorn, WI 53121-1318

Mailing address

422 N Wisconsin St
Suite a
Elkhorn, WI 53121-1318
Phone (262) 723-3235

Other identifiers 1

IdentifierTypeStateIssuer
38187200MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081013000277 WI Practitioner - Chiropractic 6507934973 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2574 Sun Valley Dr
Suite 206
Delafield, WI 53018-2334
Phone (262) 646-3221

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Performance Chiropractic, LLC Chiropractor CurrentSince Oct 1, 2014 Accepting new patients

Locations

2574 Sun Valley Dr
Ste 206
Delafield, WI 53018
Phone (262) 646-3221

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1204588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297123200000",
    "number": "1932379062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "422 N WISCONSIN ST",
            "address_2": "SUITE A",
            "city": "ELKHORN",
            "state": "WI",
            "postal_code": "531211318",
            "telephone_number": "262-723-3235",
            "fax_number": "262-723-8621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "422 N WISCONSIN ST",
            "address_2": "SUITE A",
            "city": "ELKHORN",
            "state": "WI",
            "postal_code": "531211318",
            "telephone_number": "262-723-3235",
            "fax_number": "262-723-8621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRZESINSKI",
        "first_name": "PAUL",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-04",
        "last_updated": "2011-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4432-12",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38187200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhorn, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2011; 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.