Individual provider Active NPI

Michael Jude Milbauer, DC

  • Chiropractor
  • Sartell, MN
National Provider Identifier
1043217706
Registry record updated Aug 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2895 Issued in MN
Practice address
100 2ND St S
Sartell, MN 56377-1977
Phone
(320) 251-2600
Fax
(320) 251-4763
NPI assigned
Jul 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2895 MN Primary

Addresses

Primary practice location

100 2ND St S
Sartell, MN 56377-1977

Mailing address

100 2ND St S
PO Box 296
Sartell, MN 56377-1977
Phone (320) 251-2600

Other identifiers 3

IdentifierTypeStateIssuer
18F04MIOtherMNBLUE CROSS BLUE SHIELD
4433195OtherMNMEDICA
676728100MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110107000642 MN Practitioner - Chiropractic 1456540376 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integracare LTDGroup PAC ID 6800780818, 24 clinicians

Practice addresses (Care Compare)

100 2ND St S
Sartell, MN 56377-1977
Phone 3202512600117

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2895MNMDOptometrist

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377561600000",
    "number": "1043217706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 2ND ST S",
            "address_2": "PO BOX 296",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563771977",
            "telephone_number": "320-251-2600",
            "fax_number": "320-251-4763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 2ND ST S",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563771977",
            "telephone_number": "320-251-2600",
            "fax_number": "320-251-4763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILBAUER",
        "first_name": "MICHAEL",
        "middle_name": "JUDE",
        "name_prefix": "Mr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2013-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "2895",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "18F04MI",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "4433195",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "676728100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sartell, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.