Individual provider Active NPI

Joseph Samuel Burgarino, D.C.

  • Chiropractor
  • Brookfield, WI
National Provider Identifier
1942209465
Registry record updated Jul 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1356-012 Issued in WI
Practice address
2511 N 124TH St
Suite 125
Brookfield, WI 53005-4622
Phone
(262) 789-1955
Fax
(262) 789-1955
NPI assigned
Jul 18, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1356-012 WI Primary

Addresses

Primary practice location

2511 N 124TH St
Suite 125
Brookfield, WI 53005-4622

Mailing address

2511 N 124TH St
Suite 125
Brookfield, WI 53005-4622
Phone (262) 789-1955

Other identifiers 1

IdentifierTypeStateIssuer
38804900MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101115000858 WI Practitioner - Chiropractic 9436344504 Practice locations: Brookfield, WI

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1976
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2511 N 124TH St
Brookfield, WI 53005-4679
Phone (262) 789-1955

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1356WIMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280188800000",
    "number": "1942209465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2511 N 124TH ST",
            "address_2": "SUITE 125",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530054622",
            "telephone_number": "262-789-1955",
            "fax_number": "262-789-1955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2511 N 124TH ST",
            "address_2": "SUITE 125",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530054622",
            "telephone_number": "262-789-1955",
            "fax_number": "262-789-1955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGARINO",
        "first_name": "JOSEPH",
        "middle_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-18",
        "last_updated": "2010-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "1356-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38804900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2010; 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.