ACTIVE LIFESTYLE CHIROPRACTIC,SC
NPI 1194801191
Chiropractor in Wautoma, WI
About Active Lifestyle Chiropractic,sc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ACTIVE LIFESTYLE CHIROPRACTIC,SC (NPI 1194801191) is a healthcare organization registered as a chiropractor in Wautoma, Wisconsin and active in the NPI registry since October 2006. The organization lists David Michael Gruszka, Doctor, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Active Lifestyle Chiropractic,sc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by February 28, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Active Lifestyle Chiropractic,sc, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Active Lifestyle Chiropractic,sc's NPI number?
The NPI number for Active Lifestyle Chiropractic,sc is 1194801191. It was assigned to this organization in the NPPES registry on October 31, 2006.
Where is Active Lifestyle Chiropractic,sc located?
Active Lifestyle Chiropractic,sc is located at 140 N. Townline Rd., Wautoma, WI 54982. The listed phone number is (920) 787-0122.
What is Active Lifestyle Chiropractic,sc's specialty?
The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.
Is Active Lifestyle Chiropractic,sc enrolled in Medicare?
Yes. Active Lifestyle Chiropractic,sc is registered in the Medicare PECOS enrollment system.
When is Active Lifestyle Chiropractic,sc's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Wisconsin, Clinic/Group Practice) is due for revalidation by February 28, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Active Lifestyle Chiropractic,sc?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Chiropractic) reassigns their Medicare billing to Active Lifestyle Chiropractic,sc. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Active Lifestyle Chiropractic,sc accept?
Health plans from Anthem Blue Cross and Blue Shield, CareSource (Common Ground Healthcare), HealthPartners and Quartz list Active Lifestyle Chiropractic,sc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Active Lifestyle Chiropractic,sc was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.
# Active Lifestyle Chiropractic,sc · NPI 1194801191
Chiropractor organization in Wautoma, Wisconsin. Organization record, active in the CMS NPPES registry since October 31, 2006.
## Identity
- **NPI:** 1194801191 (Entity type: Organization)
- **Enumerated:** October 31, 2006
- **Primary specialty:** Chiropractor · taxonomy 111N00000X
- **Organization subpart:** No
- **Authorized official:** David Gruszka, DOCTOR
## Practice location
- **Address:** 140 N. TOWNLINE RD., Wautoma, WI 54982-0246
- **Phone:** (920) 787-0122 · **Fax:** (920) 787-0091
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** February 28, 2027 (Non-DME Part B, Wisconsin, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 1 clinician (Chiropractic) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 22, 2020
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Source: [NPI Profile](https://npiprofile.com/npi/1194801191) · Data from the CMS NPPES public registry.