Brianna Blanck-grott, DC is a medicare enrolled "Chiropractor" provider in Crivitz, Wisconsin. Her current practice location is
709 Dyer St, Crivitz, Wisconsin. You can reach out to her office (for appointments etc.) via phone at
(715) 854-5025.
Brianna Blanck-grott is licensed to practice in Wisconsin (license number 5051) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1831587633.
Healthcare Provider's Profile
| Full Name | Brianna Blanck-grott |
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| Gender | Female |
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| Speciality | Chiropractor |
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| Location | 709 Dyer St, Crivitz, Wisconsin |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1831587633
- Provider Enumeration Date: 12/31/2014
- Last Update Date: 05/02/2018
Medicare PECOS Information:
- PECOS PAC ID: 9638495922
- Enrollment ID: I20150304000625
Medical Identifiers
Medical identifiers for Brianna Blanck-grott such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1831587633 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 111N00000X | Chiropractor | 038012744 (Illinois) | Secondary |
| 111N00000X | Chiropractor | 5051-12 (Wisconsin) | Secondary |
| 111N00000X | Chiropractor | 5051 (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. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Brianna Blanck-grott allows following entities to bill medicare on her behalf.
| Provider Name | Hart Chiropractic Center |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1053529735
PECOS PAC ID: 0345322442
Enrollment ID: O20080129000243 |
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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. Brianna Blanck-grott 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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Brianna Blanck-grott, DC
Po Box 593,
Crivitz, WI 54114-0593
Ph: (715) 854-5025 | Brianna Blanck-grott, DC
709 Dyer St,
Crivitz, WI 54114-7480
Ph: (715) 854-5025 |
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