Individual provider Active NPI

Gina M Benassi, DC, FACO,

  • Chiropractor
  • Woodbury, MN
National Provider Identifier
1619954849
Registry record updated Oct 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2985 Issued in MN
Practice address
731 Bielenberg Drive
Suite 101
Woodbury, MN 55025-1700
Phone
(651) 578-9191
Fax
(651) 702-7499
NPI assigned
Dec 29, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2985 MN Primary

Addresses

Primary practice location

731 Bielenberg Drive
Suite 101
Woodbury, MN 55025-1700

Mailing address

731 Bielenberg Drive
Suite 101
Woodbury, MN 55025-1700
Phone (651) 578-9191

Other identifiers 10

IdentifierTypeStateIssuer
41-1883279OtherFEDERAL TAX ID
02B21BEOtherMNEPNI SELECT CHIROPRACTIC
0446OtherMNHSM PROVIDER NUMBER
231918OtherMNCHIROCARE OF MN
350002251OtherMNMEDICARE ID - TYPE UNSPECIFIED
350049060OtherMNRAILROAD MEDICARE
476452OtherMNFOCUS HEALTHCARE MGMNT
498528100MedicaidMN
MN3755OtherMNPREFERRED CHIROPRACTIC CA
02B20BEOtherMNPROVIDER #

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120124000253 MN Practitioner - Chiropractic 6002860640 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

731 Bielenberg Dr
Suite 101
Woodbury, MN 55125-1701
Phone (651) 578-9191

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2985MNMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Benassi Chiropractic, P.a. Chiropractor CurrentSince Jul 25, 1997 Accepting new patients

Locations

8650 Hudson Blvd N
Ste 205
Lake Elmo, MN 55042
Phone (651) 578-9191

731 Bielenberg Dr
Ste 101
Woodbury, MN 55125
Phone (651) 578-9191

Organizations & group practices 1

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": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318550400000",
    "number": "1619954849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "731 BIELENBERG DRIVE",
            "address_2": "SUITE 101",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "550251700",
            "telephone_number": "651-578-9191",
            "fax_number": "651-702-7499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 BIELENBERG DRIVE",
            "address_2": "SUITE 101",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "550251700",
            "telephone_number": "651-578-9191",
            "fax_number": "651-702-7499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENASSI",
        "first_name": "GINA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DC, FACO,",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-29",
        "last_updated": "2011-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "2985",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL TAX ID",
            "identifier": "41-1883279",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EPNI SELECT CHIROPRACTIC",
            "identifier": "02B21BE",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HSM PROVIDER NUMBER",
            "identifier": "0446",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIROCARE OF MN",
            "identifier": "231918",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID - TYPE UNSPECIFIED",
            "identifier": "350002251",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "350049060",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FOCUS HEALTHCARE MGMNT",
            "identifier": "476452",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "498528100",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CHIROPRACTIC CA",
            "identifier": "MN3755",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER #",
            "identifier": "02B20BE",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2011; 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.