Individual provider Active NPI

Leon Boris Frid, D.C.

  • Occupational Health Chiropractor
  • St Louis Park, MN
National Provider Identifier
1639117559
Registry record updated Jul 13, 2026
On this page

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128a(1) exclusion effective Apr 18, 2024.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
Occupational Health ChiropractorTaxonomy code 111NX0100X
License
2008 Issued in MN
Practice address
3015 Utah Ave S
Suite 200
Saint Louis Park, MN 55426-3671
Phone
(952) 933-1121
Fax
(952) 945-9536
NPI assigned
Jun 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Health Chiropractor 111NX0100X 2008 MN Primary

Addresses

Primary practice location

3015 Utah Ave S
Suite 200
Saint Louis Park, MN 55426-3671

Mailing address

4201 Excelsior Blvd
St Louis Park, MN 55416-4728
Phone (952) 933-8900

Other identifiers 1

IdentifierTypeStateIssuer
506527500MedicaidMN

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)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
2008MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Care & Rehabilitation Clinics, Inc. PastSince Nov 17, 2003 Accepting new patients

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": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1639117559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 EXCELSIOR BLVD",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554164728",
            "telephone_number": "952-933-8900",
            "fax_number": "952-945-9536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 UTAH AVE S",
            "address_2": "SUITE 200",
            "city": "SAINT LOUIS PARK",
            "state": "MN",
            "postal_code": "554263671",
            "telephone_number": "952-933-1121",
            "fax_number": "952-945-9536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRID",
        "first_name": "LEON",
        "middle_name": "BORIS",
        "name_prefix": "Mr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NX0100X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Occupational Health",
            "state": "MN",
            "license": "2008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "506527500",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

Verify at the official NPI Registry.