CHN MEDICAL CENTER GREEN LAKE
NPI 1568622280
Family Medicine in Green Lake, WI

NPI Status: Active since June 16, 2008

Contact Information

670 COUNTY ROAD A
GREEN LAKE, WI
ZIP 54941
Phone: (920) 294-0100
Fax: (920) 294-0123

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  • Organization
  • Family Medicine
  • Accepts Insurance

About CHN MEDICAL CENTER GREEN LAKE

This page provides the complete NPI Profile along with additional information for Chn Medical Center Green Lake, a primary care provider established in Green Lake, Wisconsin operating as a Family Medicine. The healthcare provider is registered in the NPI registry with number 1568622280 assigned on June 2008. The practitioner's primary taxonomy code is 207Q00000X with license number 44378 (WI). The provider is registered as an organization and their NPI record was last updated 12 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The provider's is doing business as Chn Medical Center Green Lake. The authorized official of this NPI record is Mr. Thomas Krystowiak (Chief Financial Officer)

NPI
1568622280
Provider Legal Name
COMMUNITY MEDICAL CENTER OF GREEN LAKE, LLC
Other Organization Name
CHN MEDICAL CENTER GREEN LAKE
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
670 COUNTY ROAD A GREEN LAKE, WI 54941
Location Phone
(920) 294-0100
Location Fax
(920) 294-0123
Mailing Address
670 COUNTY ROAD A GREEN LAKE, WI 54941
Mailing Phone
(920) 294-0100
Mailing Fax
(920) 294-0123
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
06-16-2008
Last Update Date
05-02-2014
Code Navigator

A primary care provider (PCP) like Chn Medical Center Green Lake sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Family Medicine

Taxonomy Code
207Q00000X
Type
Allopathic & Osteopathic Physicians
License No.
44378
License State
WI
Taxonomy Description
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Premier $2,000 - 25% - HMO
  • Premier $3,500 - 30% - HMO
  • Premier $4,000 - 50% - HMO
  • Premier $5,000 HDHP - HMO
  • Premier $6,000 - 40% - HMO
  • Premier $7,500 - HMO
  • Premier $7,500 HDHP - HMO
  • Premier HMO $1,500 - 30% - HMO
  • Premier HMO $2,500 - 20% Copay - HMO
  • Premier HMO $3,400 - 30% HDHP - HMO
  • Premier HMO $3,500 - 30% - HMO
  • Premier HMO $3,500 HDHP - HMO
  • Premier HMO $4,000 - 20% HDHP - HMO
  • Premier HMO $5,000 - 20% HDHP - HMO
  • Premier HMO $5,500 - 40% Copay - HMO
  • Premier HMO $7,500 HDHP - HMO
  • Premier HMO $750 - 10% - HMO
  • Premier HMO $9,500 - HMO
  • Premier POS $1,500 - 30% - POS
  • Premier POS $2,500 - 20% Copay - POS

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. THOMAS KRYSTOWIAK

Authorized Official Title
CHIEF FINANCIAL OFFICER
Authorized Official Phone
(920) 361-1313

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
21329400MEDICAID (05)WI 
6526320001MEDICARE NSC (07)WI 
WI1031MEDICARE PIN (08)WI 

Reviews for CHN MEDICAL CENTER GREEN LAKE

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1568622280, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 60. The final step is to find the difference between that total and the next multiple of ten (60 - 60 = 0).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
5
Unchanged
Pos 3
6
Doubled → 12 → 1 + 2
Pos 4
8
Unchanged
Pos 5
6
Doubled → 12 → 1 + 2
Pos 6
2
Unchanged
Pos 7
2
Doubled → 4
Pos 8
2
Unchanged
Pos 9
8
Doubled → 16 → 1 + 6
Check
0
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 6 → 12 → 3 6 → 12 → 3 2 → 4 8 → 16 → 7

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 5 + 1 + 2 + 8 + 1 + 2 + 2 + 4 + 2 + 1 + 6 + 24 = 60

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 60 is 60. The difference is the calculated check digit.

60 - 60 = 0
This NPI is valid
The calculated check digit is 0, which matches the last digit of 1568622280.

Other Providers at the Same Location


The following 4 providers are registered at the same or a nearby location.

Family Medicine
670 COUNTY ROAD A
GREEN LAKE, WI 54941
Nurse Practitioner (Family)
670 COUNTY ROAD A
GREEN LAKE, WI 54941
Nurse Practitioner (Family)
670 COUNTY ROAD A
GREEN LAKE, WI 54941
Family Medicine
670 COUNTY ROAD A
GREEN LAKE, WI 54941

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1568622280, enumerated as an "organization" on June 16, 2008.

The provider is located at 670 COUNTY ROAD A GREEN LAKE, WI 54941 and the phone number is (920) 294-0100.

Family Medicine with taxonomy code 207Q00000X.

The provider might be accepting Accepts: Security Health Plan, Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.