Individual provider Active NPI

Brian Paul Michaelis, D.C.

  • Chiropractor
  • McCook, NE
National Provider Identifier
1679667950
Registry record updated Jul 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1240 Issued in NE
Practice address
502 W 1St St
McCook, NE 69001-3101
Phone
(308) 345-2000
Fax
(308) 345-2001
NPI assigned
Oct 3, 2006
Last updated
Jul 20, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1240 NE Primary

Addresses

Primary practice location

502 W 1St St
McCook, NE 69001-3101

Mailing address

502 W 1St St
McCook, NE 69001-3101
Phone (308) 345-2000

Other identifiers 3

IdentifierTypeStateIssuer
99563OtherNEBCBS
233783OtherNEMIDLANDS CHOICE
47055880801MedicaidNE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080429000801 NE Practitioner - Chiropractic 3870672074 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michaelis Chiropractic PCGroup PAC ID 0345329546, 2 clinicians

Practice addresses (Care Compare)

502 W 1St St
MC Cook, NE 69001-3101
Phone (308) 345-2000

Merit-based Incentive Payment System (MIPS)

Final score
23.82 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
79.41

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1240NEMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Michaelis Chiropractic PC Chiropractor CurrentSince Apr 1, 2008 Accepting new patients

Locations

502 W 1st St
McCook, NE 69001
Phone (308) 345-2000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184889600000",
    "number": "1679667950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 W 1ST ST",
            "city": "MCCOOK",
            "state": "NE",
            "postal_code": "690013101",
            "telephone_number": "308-345-2000",
            "fax_number": "308-345-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 W 1ST ST",
            "city": "MCCOOK",
            "state": "NE",
            "postal_code": "690013101",
            "telephone_number": "308-345-2000",
            "fax_number": "308-345-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHAELIS",
        "first_name": "BRIAN",
        "middle_name": "PAUL",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NE",
            "license": "1240",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "99563",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "233783",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47055880801",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McCook, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2007; 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.