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PETER ZENITHEN BOUC
NPI 1417842360
Chiropractor in Beloit, WI

Active since June 11, 2025Accepts Medicare Assignment
3005 S RIVERSIDE DR STE 103, BELOIT, WI 53511(608) 290-2775 Get Directions Write a Review

NPPES record last updated: February 13, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Peter Zenithen Bouc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PETER ZENITHEN BOUC (NPI 1417842360) is an individual chiropractor in Beloit, Wisconsin, licensed in Wisconsin (6296-12) and active in the NPI registry since June 2025. He is a graduate of Palmer College Chiropractic - Davenport (2025).

NPPES Registry Identity

NPI1417842360
Entity TypeIndividualMale
Primary Taxonomy111N00000X
Provider Legal NamePETER ZENITHEN BOUC
Location Address3005 S RIVERSIDE DR STE 103Beloit, WI 53511-1500
Mailing Address3005 S Riverside Dr Ste 103Beloit, WI 53511-1500
Phone(608) 290-2775
Sole ProprietorNo
Medical School CMSPalmer College Chiropractic - DavenportGraduated 2025
Enumeration DateJune 11, 2025
Last NPPES UpdateFebruary 13, 2026
NPPES CertifiedFebruary 13, 2026
✔ NPI 1417842360 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers
Taxonomy Code111N00000X
License✔ Licensed in WI · 6296-12
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
3005 S RIVERSIDE DR STE 103, Beloit, WI 53511
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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

Peter Zenithen Bouc 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.

PECOS PAC ID5193293488
PECOS Enrollment IDI20260505003354

Medicare Billing Reassignment

Medicare enrollment records show Peter Bouc reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Peter Bouc LLC
Same address
Chiropractor
3005 S RIVERSIDE DR STE 103
Beloit, WI 53511
  • Reassigned Medicare billing, Wisconsin enrollment
NPI 1457203119 (608) 290-2775

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 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KAYLA ELIZABETH BUTTKE COTA
Occupational Therapy Assistant
3005 S RIVERSIDE DR STE 103
BELOIT, WI 53511
Rock County (608) 313-8600
KIMBERLY LABOTT MOTR
Occupational Therapist
3005 S RIVERSIDE DR STE 103
BELOIT, WI 53511
Rock County (608) 313-8600
PETER BOUC LLC
Chiropractor
3005 S RIVERSIDE DR STE 103
BELOIT, WI 53511
Rock County (608) 290-2775
MAULY HER-LO OTR/L
Occupational Therapist
3005 S RIVERSIDE DR STE 103
BELOIT, WI 53511
Rock County (608) 313-8600
EMILY MAE BUSSANICH COTA
Occupational Therapy Assistant
3005 S RIVERSIDE DR STE 103
BELOIT, WI 53511
Rock County (608) 313-8600
KATRINA NICOLE GADSBY MS, OTR/L
Occupational Therapist
3005 S RIVERSIDE DR STE 103
BELOIT, WI 53511
Rock County (608) 313-8600

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 Peter Bouc's NPI number?

The NPI number for Peter Bouc is 1417842360. It was assigned to this individual provider in the NPPES registry on June 11, 2025.

Where is Peter Bouc located?

Peter Bouc practices at 3005 S Riverside Dr Ste 103, Beloit, WI 53511. The listed phone number is (608) 290-2775.

What is Peter Bouc's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Is Peter Bouc enrolled in Medicare?

Yes. Peter Bouc 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 Peter Bouc's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Peter Bouc reassigns Medicare benefits to Peter Bouc LLC (Beloit, 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 Peter Bouc'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 Peter Bouc was last updated on February 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months 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.