Individual provider Active NPI

Bradley Donald Kaasa, DC

  • Chiropractor
  • North Bend, WA
National Provider Identifier
1447349592
Registry record updated Jan 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3216 Issued in WA
Practice address
325 E 3Rd St
North Bend, WA 98045-8250
Phone
(425) 831-2331
Fax
(866) 462-2960
NPI assigned
Oct 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 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 3216 WA Primary

Addresses

Primary practice location

325 E 3Rd St
North Bend, WA 98045-8250

Mailing address

PO Box 911
North Bend, WA 98045
Phone (425) 831-2331

Other identifiers 2

IdentifierTypeStateIssuer
OA3358OtherWAREGENCE BLUE SHIELD
117064OtherWALABOR & INDUSTRIES

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040513000158 WA Practitioner - Chiropractic 2860482874 Practice locations: North Bend, WA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

325 E 3Rd St
North Bend, WA 98045-8250
Phone (425) 831-2331

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3216WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
North Bend Chiropractic and Golf Fitness Center PLLC CurrentSince Jan 26, 2020 Accepting new patients
Rosewater Healing Arts and Massage Past Accepting new patients

Locations

325 E 3rd St
North Bend, WA 98045
Phone (425) 831-2331

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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579651200000",
    "number": "1447349592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 911",
            "city": "NORTH BEND",
            "state": "WA",
            "postal_code": "98045",
            "telephone_number": "425-831-2331",
            "fax_number": "425-831-2244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 E 3RD ST",
            "city": "NORTH BEND",
            "state": "WA",
            "postal_code": "980458250",
            "telephone_number": "425-831-2331",
            "fax_number": "866-462-2960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAASA",
        "first_name": "BRADLEY",
        "middle_name": "DONALD",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "3216",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "OA3358",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "117064",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Bend, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 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.