Individual provider Active NPI

Kyle Politz, DC

  • Chiropractor
  • Minneapolis, MN
National Provider Identifier
1164987228
Registry record updated Nov 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6595 Issued in MN
Practice address
6528 W Lake St Ste D
Minneapolis, MN 55426-4246
Phone
(952) 977-9944
NPI assigned
Feb 4, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 6595 MN Primary

Addresses

Primary practice location

6528 W Lake St Ste D
Minneapolis, MN 55426-4246

Mailing address

6528 W Lake St Ste D
Minneapolis, MN 55426-4246
Phone (952) 977-9944

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190313001100 MN Practitioner - Chiropractic 6406196377 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6528 W Lake St
Suite D
Minneapolis, MN 55426-4246
Phone (952) 977-9944

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Elevate Chiropractic LLC Chiropractor CurrentSince Jun 2, 2020 Accepting new patients

Locations

6528 W Lake St
Minneapolis, MN 55426

6528 W Lake St
Ste D
Minneapolis, MN 55426
Phone (952) 977-9944

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": "1549238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605052800000",
    "number": "1164987228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6528 W LAKE ST STE D",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554264246",
            "telephone_number": "952-977-9944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6528 W LAKE ST STE D",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554264246",
            "telephone_number": "952-977-9944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLITZ",
        "first_name": "KYLE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-02-04",
        "last_updated": "2020-11-11",
        "certification_date": "2020-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "6595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2020; 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.