Individual provider Active NPI

Robert Neil Privratsky Jr., DC

  • Chiropractor
  • Minneapolis, MN
National Provider Identifier
1639235161
Registry record updated Nov 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6568 Issued in MN
Practice address
1216 W Lake St
Minneapolis, MN 55408-2761
Phone
(612) 345-5376
NPI assigned
Dec 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DCP00528 RI
Chiropractor 111N00000X DC-30794 CA
Chiropractor 111N00000X 6568 MN Primary

Addresses

Primary practice location

1216 W Lake St
Minneapolis, MN 55408-2761

Mailing address

1216 W Lake St
Minneapolis, MN 55408-2761
Phone (612) 345-5376

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL MINNEAPOLIS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191113003365 MN Practitioner - Chiropractic 7315967304 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1216 W Lake St
Minneapolis, MN 55408-2761
Phone (612) 345-5376

6550 York Ave S
Suite 210
Edina, MN 55435-2333

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. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
DC-30794CAMDChiropractor
DCP00528RIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Privratsky Chiropractic PC CurrentSince Aug 19, 2019 Accepting new patients
Northeast Chiropractic Chiropractor PastSince Jan 3, 2007 Accepting new patients
Nielson Family Chiropractic PLLC Chiropractor PastSince Nov 10, 2019 Accepting new patients

Locations

1216 W Lake St
Minneapolis, MN 55408
Phone (612) 345-5376

Organizations & group practices 3

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": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572825600000",
    "number": "1639235161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1216 W LAKE ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554082761",
            "telephone_number": "612-345-5376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1216 W LAKE ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554082761",
            "telephone_number": "612-345-5376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIVRATSKY",
        "first_name": "ROBERT",
        "middle_name": "NEIL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-29",
        "last_updated": "2019-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "RI",
            "license": "DCP00528",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC-30794",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "6568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "MINNEAPOLIS",
            "affiliation": "N",
            "address_1": "1216 W Lake St",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554082761",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2019; 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.