Active NPI
Joseph M Grausgruber, D.C.
- Chiropractor
- Fargo, ND
National Provider Identifier
1083788012
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 1072
- Practice address
- 4674 40TH Ave S Ste B
Fargo, ND 58104-4501 - Phone
- (701) 364-4105
- NPI assigned
- Nov 20, 2006
- Last updated
- Sep 27, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1072 | ND | Primary |
Addresses
Primary practice location
4674 40TH Ave S Ste B
Fargo, ND 58104-4501
Mailing address
4674 40TH Ave S Ste B
Fargo, ND 58104-4501
Phone (701) 364-4105
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7433163 | Other | PA | AETNA |
| 20-1808943 | Other | PA | TAX ID |
| 251782835 | Other | PA | ASHN |
| 408566 | Other | PA | HIGHMARK |
| 02694600 | Other | PA | CAPITAL BC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ND
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Northwestern College of Chiropractic, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
4674 40TH Ave S
Suite B
Fargo, ND 58104-4501
Phone (701) 364-4105
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1072 | ND | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Van Dam Chiropractic, PC | Current | Accepting new patients | |
| Hershey 1 LLC | Chiropractor | Past | Accepting new patients |
Locations
1203 28th St S
#B
Fargo, ND 58103
Phone (701) 532-5320
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Be Active Chiropractic
- Chiropractor
- Fargo, ND
- NPI 1992833909
-
- Point of Service
- Fargo, ND
- NPI 1205038023
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695772800000",
"number": "1083788012",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4674 40TH AVE S STE B",
"city": "FARGO",
"state": "ND",
"postal_code": "581044501",
"telephone_number": "701-364-4105"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4674 40TH AVE S STE B",
"city": "FARGO",
"state": "ND",
"postal_code": "581044501",
"telephone_number": "701-364-4105"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAUSGRUBER",
"first_name": "JOSEPH",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-20",
"last_updated": "2023-09-27",
"certification_date": "2023-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "ND",
"license": "1072",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7433163",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "20-1808943",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ASHN",
"identifier": "251782835",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK",
"identifier": "408566",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAPITAL BC",
"identifier": "02694600",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2023; 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.