Kelly Rae Schwartzbauer

Primary specialty

DentistTaxonomy code 122300000X

License

D13039 Issued in MN

Practice address

277 3Rd St N
Bayport, MN 55003-1028

Phone

(651) 439-2352

NPI assigned

Oct 16, 2012

Last updated

Feb 8, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Nathan J. Jensen, DMD, PLLC

  dba Filson Gentle Dentistry

  • Dentist
  • Bayport, MN
  • NPI 1467112037
  NPD
• Bruce F Filson DDS PA

  dba Filson Gentle Dentistry

  • General Practice Dentistry
  • Bayport, MN
  • NPI 1225107998
  NPD (past)

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

{
    "created_epoch": "1350345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675814400000",
    "number": "1215280144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6670 GLEN RD",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551299506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "277 3RD ST N",
            "city": "BAYPORT",
            "state": "MN",
            "postal_code": "550031028",
            "telephone_number": "651-439-2352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHWARTZBAUER",
        "first_name": "KELLY",
        "middle_name": "RAE",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-16",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D13039",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D13039",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mena Otoo
• Katherine Lynn Parker
• Rosalie Pierce-Martin, RD
• Brent D. Plackner, PA-C
• Stanley Dwight Quanbeck, M.D.
• William B Shea, D.D.S.
• Cynthia Silva, RDN, LD
• Vitality Chiropractic, LLC
• David William Wieden, D.C.
• Tara K Woodland, CNP

• Dentist in Bayport, MN
• Providers in Bayport, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.