NPIMap

Organization Active NPI

Matousek Chiropractic, P.a.

Doing business as Real Health Chiropractic Clinic

  • Chiropractor
  • Eden Prairie, MN
National Provider Identifier
1689752750
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3818 Issued in MN
Legal business name
MATOUSEK CHIROPRACTIC, P.A.
Doing business as
Real Health Chiropractic Clinic
Practice address
8901 Aztec Dr
Eden Prairie, MN 55347-1916
Phone
(952) 224-0607
Fax
(952) 224-2418
NPI assigned
Nov 2, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Sharhae Angela Matousek, D.C.NPI 1851404966
Title
President
Phone
(952) 224-0607

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3818 MN Primary

Addresses

Primary practice location

8901 Aztec Dr
Eden Prairie, MN 55347-1916

Mailing address

8901 Aztec Dr
Eden Prairie, MN 55347-1916
Phone (952) 224-0607

Other identifiers 1

IdentifierTypeStateIssuer
10841700MedicaidMN

Other names 1

  • Real Health Chiropractic Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040210000078 MN Part B Supplier - Clinic/Group Practice 4981598174 Receives reassigned benefits from 1 practitioner
Practice locations: Eden Prairie, MN

National Provider Directory

National Provider Directory

Locations

8901 Aztec Dr
Eden Prairie, MN 55347
Phone (952) 224-0607

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689752750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8901 AZTEC DR",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553471916",
            "telephone_number": "952-224-0607",
            "fax_number": "952-224-2418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8901 AZTEC DR",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553471916",
            "telephone_number": "952-224-0607",
            "fax_number": "952-224-2418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATOUSEK CHIROPRACTIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MATOUSEK",
        "authorized_official_first_name": "SHARHAE",
        "authorized_official_middle_name": "ANGELA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "952-224-0607",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3818",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10841700",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Real Health Chiropractic Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eden Prairie, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.