Individual provider Active NPI

Michael Scott Balfanz, DC

  • Chiropractor
  • Saint Cloud, MN
National Provider Identifier
1730102302
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3548 Issued in MN
Practice address
48 29TH Ave N
Saint Cloud, MN 56303-4589
Phone
(320) 240-0300
Fax
(320) 240-0303
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3548 MN Primary

Addresses

Primary practice location

48 29TH Ave N
Saint Cloud, MN 56303-4589

Mailing address

48 29TH Ave N
Saint Cloud, MN 56303-4589
Phone (320) 240-0300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040811000932 MN Practitioner - Chiropractic 2163494923 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Woodlands Chiropractic PAGroup PAC ID 2466350269, 4 clinicians

Practice addresses (Care Compare)

48 29TH Ave N
Saint Cloud, MN 56303-4589
Phone (320) 240-0300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3548MNMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Woodlands Chiropractic PA Chiropractor CurrentSince Dec 1, 2013 Accepting new patients
Flying Cloud Physical Therapy, P.a. Past Accepting new patients
Flying Cloud Spine & Sport, P.a. Chiropractor Past Accepting new patients
Integrated Care Clinics, PA PastSince Jul 22, 2015 Accepting new patients

Locations

48 29th Ave N
Saint Cloud, MN 56303
Phone (320) 240-0300

Organizations & group practices 4

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": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1730102302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 29TH AVE N",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563034589",
            "telephone_number": "320-240-0300",
            "fax_number": "320-240-0303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 29TH AVE N",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563034589",
            "telephone_number": "320-240-0300",
            "fax_number": "320-240-0303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALFANZ",
        "first_name": "MICHAEL",
        "middle_name": "SCOTT",
        "name_prefix": "Mr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.