DR. WALTER RUDOLPH WIESZTORT D.C.
NPI 1003814336
Chiropractor in Kenosha, WI
About Dr. Walter Rudolph Wiesztort D.c. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. WALTER RUDOLPH WIESZTORT D.C. (NPI 1003814336) is an individual chiropractor in Kenosha, Wisconsin, licensed in Wisconsin (3514-012) and active in the NPI registry since July 2005. He is a graduate of Palmer College Chiropractic - Davenport (1997).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 8
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Walter Rudolph Wiesztort D.c. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Walter Wiesztort reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Kenosha, WI 53142
- Reassigned Medicare billing, Wisconsin enrollment
- Medicare enrollment name: Wiesztort Family Chiropractic Clinic Sc
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
KENOSHA, WI 53142
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Walter Wiesztort's NPI number?
The NPI number for Walter Wiesztort is 1003814336. It was assigned to this individual provider in the NPPES registry on July 11, 2005.
Where is Walter Wiesztort located?
Walter Wiesztort practices at 4014 77th St Ste. 2, Kenosha, WI 53142. The listed phone number is (262) 694-3530.
What is Walter Wiesztort's specialty?
The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.
Is Walter Wiesztort enrolled in Medicare?
Yes. Walter Wiesztort is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Walter Wiesztort's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Walter Wiesztort reassigns Medicare benefits to Wiesztort Family Chiropractic Clinic, S.C. (Kenosha, WI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Walter Wiesztort's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Walter Wiesztort was last updated on April 22, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr. Walter Rudolph Wiesztort, D.C. · NPI 1003814336
Chiropractor provider in Kenosha, Wisconsin. Individual provider, active in the CMS NPPES registry since July 11, 2005.
## Identity
- **NPI:** 1003814336 (Entity type: Individual)
- **Enumerated:** July 11, 2005
- **Primary specialty:** Chiropractor · taxonomy 111N00000X
- **State license:** 3514-012 (Wisconsin)
- **Sole proprietor:** No
## Practice location
- **Address:** 4014 77TH ST, STE. 2, Kenosha, WI 53142-4314
- **Phone:** (262) 694-3530 · **Fax:** (262) 925-8810
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Bills Medicare through:** Wiesztort Family Chiropractic Clinic, S.C. (NPI 1033281167, Kenosha, WI), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Palmer College Chiropractic - Davenport, class of 1997
## Record status
- **NPPES last updated:** April 22, 2008
- **Other identifiers:** Other 0005896742; Other 4400259; Other 0191565; and 5 more
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Source: [NPI Profile](https://npiprofile.com/npi/1003814336) · Data from the CMS NPPES public registry.