Kayvon Behnam, D.C.
Individual provider Active NPI Chiropractor · Red Wing, MN
NPI 1487775987 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1487775987
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 3644 (MN)
- Practice address
- 104 Burnside Ave S
Red Wing, MN 55066-1928 - Phone
- (651) 267-0394
- NPI assigned
- Apr 2, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Northwestern College of Chiropractic, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
104 Burnside Ave S
Red Wing, MN 55066-1928
Phone (651) 267-0394
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040115000036 | MN | Practitioner - Chiropractic | 4981505898 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 3644 | MN | Yes |
Addresses
Primary practice location
104 Burnside Ave S
Red Wing, MN 55066-1928
Mailing address
104 Burnside Ave S
Red Wing, MN 55066-1928
Phone (651) 267-0394
Other providers in Red Wing, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.