Redgranite Family Chiropractic is a medicare enrolled "Chiropractor" provider in Redgranite, Wisconsin. Their current practice location is
1100 E Bannerman Avenue, Suite 2, Redgranite, Wisconsin. You can reach out to their office (for appointments etc.) via phone at
(920) 566-0767.
Redgranite Family Chiropractic is licensed to practice in Wisconsin (license number 4106) and it also participates in the medicare program. Redgranite Family Chiropractic
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1245337559.
Healthcare Provider's Profile
| Full Name | Redgranite Family Chiropractic |
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| Type | Facility |
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| Speciality | Chiropractor |
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| Location | 1100 E Bannerman Avenue, Redgranite, Wisconsin |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1245337559
- Provider Enumeration Date: 09/20/2006
- Last Update Date: 07/26/2013
Medicare PECOS Information:
- PECOS PAC ID: 5991700064
- Enrollment ID: O20060922000472
Medical Identifiers
Medical identifiers for Redgranite Family Chiropractic such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1245337559 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 111N00000X | Chiropractor | 4106 (Wisconsin) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Redgranite Family Chiropractic acts as a billing entity for following providers:
| Provider Name | Eric S Boettcher |
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| Provider Type | Practitioner - Chiropractic |
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| Provider Identifiers | NPI Number: 1750306957
PECOS PAC ID: 2668428558
Enrollment ID: I20050323001214 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Redgranite Family Chiropractic is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Redgranite Family Chiropractic
Po Box 447,
Redgranite, WI 54970-0447
Ph: (920) 566-0767 | Redgranite Family Chiropractic
1100 E Bannerman Avenue, Suite 2,
Redgranite, WI 54970
Ph: (920) 566-0767 |
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