Individual provider Active NPI

Michael Troy Schomaker, D.C., B.S.

  • Chiropractor
  • Elk River, MN
National Provider Identifier
1336134972
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3405 Issued in MN
Practice address
19022 Freeport St NW
Suite D
Elk River, MN 55330
Phone
(763) 253-2000
Fax
(763) 241-2191
NPI assigned
Sep 20, 2005
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3405 MN Primary

Addresses

Primary practice location

19022 Freeport St NW
Suite D
Elk River, MN 55330

Mailing address

19022 Freeport St NW
Suite D
Elk River, MN 55330
Phone (763) 253-2000

Other identifiers 3

IdentifierTypeStateIssuer
5C767SCOtherMNBLUE CROSS BLUE SHIELD
2161850OtherMNFIRST HEALTH
93401OtherMNHEALTHPARTNERS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040310001502 MN Practitioner - Chiropractic 6406745330 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

19022 Freeport St NW
Suite D
Elk River, MN 55330-4767
Phone (763) 253-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Schomaker Chiropractic Clinic, P.C. Chiropractor CurrentSince Sep 2, 2003 Accepting new patients

Locations

19022 Freeport St NW
Ste D
Elk River, MN 55330
Phone (763) 253-2000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1336134972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19022 FREEPORT ST NW",
            "address_2": "SUITE D",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "55330",
            "telephone_number": "763-253-2000",
            "fax_number": "763-241-2191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19022 FREEPORT ST NW",
            "address_2": "SUITE D",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "55330",
            "telephone_number": "763-253-2000",
            "fax_number": "763-241-2191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHOMAKER",
        "first_name": "MICHAEL",
        "middle_name": "TROY",
        "name_prefix": "Dr.",
        "credential": "D.C., B.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "5C767SC",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "2161850",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "93401",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk River, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.