Kellen Blanck-grott, DC is a medicare enrolled "Chiropractor" provider in Crivitz, Wisconsin. He graduated from medical school in 2015 and has 9 years of diverse experience with area of expertise as Chiropractic. His current practice location is
709 Dyer St, Crivitz, Wisconsin. You can reach out to his office (for appointments etc.) via phone at
(715) 854-5025.
Kellen Blanck-grott is licensed to practice in Wisconsin (license number 5160-12) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1306200472.
Healthcare Provider's Profile
| Full Name | Kellen Blanck-grott |
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| Gender | Male |
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| Speciality | Chiropractic |
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| Experience | 9 Years |
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| Location | 709 Dyer St, Crivitz, Wisconsin |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Kellen Blanck-grott graduated from medical school in 2015
NPI Data:
- NPI Number: 1306200472
- Provider Enumeration Date: 04/05/2016
- Last Update Date: 07/12/2018
Medicare PECOS Information:
- PECOS PAC ID: 4082902598
- Enrollment ID: I20161017002543
Medical Identifiers
Medical identifiers for Kellen Blanck-grott such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1306200472 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 111N00000X | Chiropractor | 5160-12 (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. Kellen Blanck-grott allows following entities to bill medicare on his behalf.
| Provider Name | Northern Chiropractic And Wellness Llc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1619427630
PECOS PAC ID: 0547558058
Enrollment ID: O20161017002413 |
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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. Kellen 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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Kellen Blanck-grott, DC
709 Dyer St,
Crivitz, WI 54114-7480
Ph: (715) 854-5025 | Kellen Blanck-grott, DC
709 Dyer St,
Crivitz, WI 54114
Ph: (715) 854-5025 |
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