CRAIG S CHERTACK (NPI# 1811979487) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811979487 |
| Entity Type | Individual |
| Full Name | CRAIG S CHERTACK |
| Credential | M.D. |
| Practice Address |
225 Memorial Dr Berlin WI 54923-1243 |
| Mailing Address |
331 Forestview Dr Williamsville NY 14221-1460 |
| Practice Telephone | 9203611313 |
| Mailing Telephone | 7166897541 |
| Mailing Fax Number | 7166897541 |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2018-03-28 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 169890 | NY | Other Service Providers |
| N | 207X00000X | Orthopaedic Surgery | 18247 | WI | Allopathic & Osteopathic Physicians |
| N | 207X00000X | Orthopaedic Surgery | 169890 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | MEDICARE GROUP NUMBER | 076011 | 01 |
| Street Address |
225 MEMORIAL DR |
| City | BERLIN |
| State | WI |
| Zip Code | 54923-1243 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962403832 | M Jean Bruce | Family Medicine | 225 Memorial Dr, Suite 1200, Berlin, WI 54923-1243 | 2005-08-02 |
| 1841814472 | Benjamin John Kozloski | Nurse Anesthetist, Certified Registered | 225 Memorial Dr, Berlin, WI 54923-1243 | 2020-05-29 |
| 1003439720 | Courtney Disterhaft | Physical Therapist | 225 Memorial Dr, Berlin, WI 54923-1243 | 2020-05-28 |
| 1457911984 | Nolan S Baker | Speech-Language Pathologist | 225 Memorial Dr, Berlin, WI 54923-1243 | 2019-06-17 |
| 1477043313 | Lina D Ramos | Registered Nurse | 225 Memorial Dr, Berlin, WI 54923 | 2018-05-16 |
| 1891291167 | Northeast Wisconsin Foot and Ankle Assoc., S.c. | Podiatrist | 225 Memorial Dr, Berlin, WI 54923-1243 | 2018-04-04 |
| 1437606373 | Sherry Lynn Reinsbach | Occupational Therapy Assistant | 225 Memorial Dr, Berlin, WI 54923-1243 | 2016-09-08 |
| 1528513272 | Jessica M Braun | Physical Therapy Assistant | 225 Memorial Dr, Berlin, WI 54923-1243 | 2016-08-23 |
| 1326592270 | Brandon Eric Mcmullen | Physical Therapist | 225 Memorial Dr, Berlin, WI 54923-1243 | 2016-08-09 |
| 1508310467 | Marissa Marie Schleis | Physical Therapist | 225 Memorial Dr, Berlin, WI 54923-1243 | 2016-08-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053910067 | Mary Ellen F Pumper | Pharmacist | 861 County Rd F, Berlin, WI 54923 | 2020-10-21 |
| 1962020792 | Brown Wilcox Trustees, Inc. | Home Health | 347 East Huron Street, Berlin, WI 54923 | 2020-07-08 |
| 1083050942 | Veterinary Clinic Berlin/ripon | Veterinarian | W1915 Cty Road F, Berlin, WI 54923 | 2013-05-20 |
| 1114078243 | David Earl Johanknecht | Optometrist | 269 Memorial Dr, Suite 103, Berlin, WI 54923 | 2007-01-16 |
| 1043314677 | William Harold Hastreiter | Dentist | 102 W Huron St, Berlin, WI 54923 | 2006-09-12 |
| 1699725333 | Kurt Alan Zemke | Dentist | 280 South Church St, Berlin, WI 54923 | 2006-05-11 |
| 1942280821 | Dina N Nelson | Nurse Anesthetist, Certified Registered | 225 Memorial Drive, Anesthesia Dept, Berlin, WI 54923 | 2006-01-18 |
| 1679574453 | Craig Batley | Family Medicine | W832 Hwy 91, Suite 3, Berlin, WI 54923 | 2005-08-03 |
| 1760887392 | Waushara Dental Associate Sc | Dentist | 322 Broadway, Berlin, WI 54923 | 2014-10-24 |
| 1750673513 | Kristy E Wagner | Occupational Therapy Assistant | 225 Memorial Drive, Berlin, WI 54923 | 2011-05-11 |
| Find all providers in zip 54923 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811453715 | Megan Hines | Specialist | 313a Bay St, Berlin, MD 21811-1207 | 2019-02-15 |
| 1871640599 | Zakir Hussain | Specialist | 54 Willow St, Berlin, NH 03570-2084 | 2007-01-04 |
| 1063511061 | Tina Lorene Swanke | Specialist | 147 N State St, Berlin, WI 54923-1621 | 2006-09-22 |
| 1578559563 | Jeffrey E. Fernley | Specialist | 9733 Healthway Drive, Berlin, MD 21811 | 2005-09-23 |
| 1801079702 | Health Professionals of Holmes County, Inc | Specialist | 4900 Oak Street, Berlin, OH 44610 | 2007-12-13 |
| 1831289107 | Back & Body Therapeutic Touch, LLC | Specialist | 147 N State St, Berlin, WI 54923-1621 | 2006-10-14 |
| 1114023165 | Dolores Rhymer-anderson | Specialist | 11107 Racetrack Road, Berlin, MD 21811-3279 | 2006-09-16 |
| 1598872731 | Nitin Verma | Specialist | 314 Franklin Ave, Ste 402, Berlin, MD 21811 | 2006-08-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043835440 | Michael Dale Shoultz | Specialist | 2622 Hoard St, Madison, WI 53704-4827 | 2020-06-11 |
| 1134752934 | Denise Douglass | Specialist | 31 Northstar Ln, Saint Croix Falls, WI 54024-9005 | 2020-02-20 |
| 1164065025 | Susan Jane Janz | Specialist | 1014 W Thomas St, Wausau, WI 54401-5986 | 2019-10-23 |
| 1518508803 | Cheryl Ann Johnson | Specialist | 830 Edgewood Dr., Green Bay, WI 54311 | 2019-10-08 |
| 1982161048 | Natalia Roman | Specialist | 725 W Lapham Blvd Apt 17, Milwaukee, WI 53204-3447 | 2019-02-25 |
| 1598231524 | Shanel Marie Jordan | Specialist | 4827 N 76th St, Milwaukee, WI 53218-3826 | 2018-10-17 |
| 1386191799 | Dallas Roger Loukes | Specialist | 323 W Monroe St, Wyocena, WI 53969 | 2016-09-01 |
| 1285084368 | Madison Swim Academy | Specialist | 605 Chase Blvd, Sun Prairie, WI 53590-2382 | 2016-06-20 |
| 1851745905 | Kristyn Zahorik | Specialist | 7515 W Coldspring Rd, Greenfield, WI 53220-2814 | 2016-04-14 |
| 1104297274 | Andrea Renee Keapproth | Specialist | 433 W Washington Ave, Madison, WI 53703-3482 | 2015-10-14 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.