Individual provider Active NPI

Scott R Corbett, D.O.

  • Neuromusculoskeletal Medicine & OMM Physician
  • Saint Louis Park, MN
National Provider Identifier
1760564108
Registry record updated Oct 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X
License
41370 Issued in MN
Practice address
3601 Park Center Blvd Ste 308
Saint Louis Park, MN 55416-2525
Phone
(952) 920-0846
Fax
(952) 920-0846
NPI assigned
Oct 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM Physician 204D00000X 41370 MN Primary

Addresses

Primary practice location

3601 Park Center Blvd Ste 308
Saint Louis Park, MN 55416-2525

Mailing address

8120 Penn Ave S
Ste 440
Bloomington, MN 55431-1326
Phone (952) 920-0846

Other identifiers 2

IdentifierTypeStateIssuer
003560200MedicaidMN
70D62COOtherBC/BS PROVIDER ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100518000866 MN Practitioner - Osteopathic Manipulative Medicine 8325177058 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Osteopathic Manipulative Medicine
Education
College of Osteo Med of the Pacific at Pomona, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8120 Penn Ave S
Suite 440
Bloomington, MN 55431-1326
Phone (952) 920-0846

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Stillpoint Osteopathic, LTD. CurrentSince Nov 1, 1999 Accepting new patients

Locations

8120 Penn Ave S
Ste 440
Minneapolis, MN 55431
Phone (952) 920-0844

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": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570838400000",
    "number": "1760564108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8120 PENN AVE S",
            "address_2": "STE 440",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554311326",
            "telephone_number": "952-920-0846",
            "fax_number": "952-920-0846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 PARK CENTER BLVD STE 308",
            "city": "SAINT LOUIS PARK",
            "state": "MN",
            "postal_code": "554162525",
            "telephone_number": "952-920-0846",
            "fax_number": "952-920-0846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORBETT",
        "first_name": "SCOTT",
        "middle_name": "R",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2019-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "MN",
            "license": "41370",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003560200",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS PROVIDER ID",
            "identifier": "70D62CO",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis Park, MN

Sources for this page

Verify at the official NPI Registry.