Individual provider Active NPI

Chad C Puffer, DO

  • Psychiatry Physician
  • Rochester, MN
National Provider Identifier
1619263985
Registry record updated Oct 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
55432 Issued in MN
Practice address
5255 Members Pkwy NW
Rochester, MN 55901-8381
Phone
(507) 218-3701
NPI assigned
Jun 24, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Child & Adolescent Psychiatry Physician 2084P0804X 55432 MN
Psychiatry Physician 2084P0800X 55432 MN Primary

Addresses

Primary practice location

5255 Members Pkwy NW
Rochester, MN 55901-8381

Mailing address

5255 Members Pkwy NW
Rochester, MN 55901-8381
Phone (507) 218-3701

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)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
55432MNMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Croix Psychiatric, LLC Psychiatry CurrentSince Sep 19, 2022 Accepting new patients
Prairiecare LLC Psychiatry PastSince Oct 13, 2019 Accepting new patients

Locations

12915 63rd Ave N
Maple Grove, MN 55369
Phone (763) 383-5800

5255 Members Pkwy NW
Rochester, MN 55901
Phone (507) 218-3701

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": "1308873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570492800000",
    "number": "1619263985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5255 MEMBERS PKWY NW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559018381",
            "telephone_number": "507-218-3701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5255 MEMBERS PKWY NW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559018381",
            "telephone_number": "507-218-3701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUFFER",
        "first_name": "CHAD",
        "middle_name": "C",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-24",
        "last_updated": "2019-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MN",
            "license": "55432",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "55432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.