Active NPI
Daniel Augustine, CAPS
- Home Modifications Contractor
- Minneapolis, MN
National Provider Identifier
1376713818
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Modifications Contractor
- License
- 20065360
- Practice address
- 509 W 22ND St
LL
Minneapolis, MN 55405-3202 - Phone
- (612) 724-1911
- Fax
- (612) 724-1851
- NPI assigned
- Mar 11, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Home Modifications Contractor | 171WH0202X | 20065360 | MN | Primary |
Addresses
Primary practice location
509 W 22ND St
LL
Minneapolis, MN 55405-3202
Mailing address
509 W 22ND St
LL
Minneapolis, MN 55405-3202
Phone (612) 724-1911
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 171562 | Other | MN | U CARE MN |
| 715314700 | Medicaid | MN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20065360 | MN | MD | Home Modifications Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205193600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1303171200000",
"number": "1376713818",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "509 W 22ND ST",
"address_2": "LL",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554053202",
"telephone_number": "612-724-1911",
"fax_number": "612-724-1851"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "509 W 22ND ST",
"address_2": "LL",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554053202",
"telephone_number": "612-724-1911",
"fax_number": "612-724-1851"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AUGUSTINE",
"first_name": "DANIEL",
"name_prefix": "Mr.",
"credential": "CAPS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-03-11",
"last_updated": "2011-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "171WH0202X",
"taxonomy_group": "",
"desc": "Contractor, Home Modifications",
"state": "MN",
"license": "20065360",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "U CARE MN",
"identifier": "171562",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "715314700",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Minneapolis, MN
- Augustana Community Partners (Augustana Signe Burckhardt)
- Augustana Mount Olivet Hospice Care LLC (Grace Palliative Care)
- Augustana Mount Olivet Hospice Care LLC
- Joshua Ryan Augustin, D.O.
- Daniel Augustinack
- Virginia Aumann, LGSW
- Danielle Aune, MA, LPCC, LADC
- Win Aung
- Aunique Home Care and Services, Inc.
- Ashley Aurig
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.