Individual provider Active NPI

Kevin Matthew Quaas, DC

  • Chiropractor
  • White Bear Lake, MN
National Provider Identifier
1427126176
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3314 Issued in MN
Practice address
4436 Hwy 61
White Bear Lake, MN 55110-3720
Phone
(651) 426-5459
Fax
(651) 426-1329
NPI assigned
Dec 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 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 3314 MN Primary

Addresses

Primary practice location

4436 Hwy 61
White Bear Lake, MN 55110-3720

Mailing address

4436 Hwy 61
White Bear Lake, MN 55110-3720
Phone (651) 426-5459

Other identifiers 1

IdentifierTypeStateIssuer
154019000MedicaidMN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091208000170 MN Practitioner - Chiropractic 5799728887 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4651 White Bear Pkwy
White Bear Lake, MN 55110-3300
Phone (651) 426-5456

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kevin M Quaas Inc Chiropractor CurrentSince Sep 8, 2009 Accepting new patients
R.J. Sass, Inc. Chiropractor Past Accepting new patients

Locations

4436 Highway 61 N
White Bear Lk, MN 55110
Phone (651) 426-5459

4651 White Bear Pkwy
White Bear Lk, MN 55110
Phone (651) 426-5456

Organizations & group practices 2

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": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427126176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4436 HWY 61",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551103720",
            "telephone_number": "651-426-5459",
            "fax_number": "651-426-1329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4436 HWY 61",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551103720",
            "telephone_number": "651-426-5459",
            "fax_number": "651-426-1329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUAAS",
        "first_name": "KEVIN",
        "middle_name": "MATTHEW",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3314",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "154019000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in White Bear Lake, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.