Organization Active NPI

Benassi Chiropractic, P.a.

  • Chiropractor
  • Woodbury, MN
National Provider Identifier
1770780504
Registry record updated Oct 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2985 Issued in MN
Legal business name
BENASSI CHIROPRACTIC, P.A.
Practice address
731 Bielenberg Dr
Suite 101
Woodbury, MN 55125-1700
Phone
(651) 578-9191
Fax
(651) 702-7499
NPI assigned
Jun 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2011

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

Authorized official

Name
Dr. Gina M. Benassi, D.C., F.A.C.O.NPI 1619954849
Title
President
Phone
(651) 578-9191

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 2985 MN Primary

Addresses

Primary practice location

731 Bielenberg Dr
Suite 101
Woodbury, MN 55125-1700

Mailing address

731 Bielenberg Dr
Suite 101
Woodbury, MN 55125-1700
Phone (651) 578-9191

Other identifiers 7

IdentifierTypeStateIssuer
3335029OtherMNMN TAX ID
1B02B20BEOtherMNBCBS
231918OtherMNCHIRO CARE
498528100MedicaidMN
7740072OtherMNAETNA
1619954849OtherMNINDIVIDUAL NPI
02B20BEOtherMNBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050307000073 MN Part B Supplier - Clinic/Group Practice 1658325378 Receives reassigned benefits from 1 practitioner
Practice locations: Woodbury, MN

National Provider Directory

National Provider Directory

Locations

8650 Hudson Blvd N
Ste 205
Lake Elmo, MN 55042
Phone (651) 578-9191

731 Bielenberg Dr
Ste 101
Woodbury, MN 55125
Phone (651) 578-9191

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317686400000",
    "number": "1770780504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "731 BIELENBERG DR",
            "address_2": "SUITE 101",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551251700",
            "telephone_number": "651-578-9191",
            "fax_number": "651-702-7499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 BIELENBERG DR",
            "address_2": "SUITE 101",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551251700",
            "telephone_number": "651-578-9191",
            "fax_number": "651-702-7499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENASSI CHIROPRACTIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-27",
        "last_updated": "2011-10-04",
        "status": "A",
        "authorized_official_last_name": "BENASSI",
        "authorized_official_first_name": "GINA",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "651-578-9191",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C., F.A.C.O."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "2985",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN TAX ID",
            "identifier": "3335029",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1B02B20BE",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIRO CARE",
            "identifier": "231918",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "498528100",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7740072",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1619954849",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "02B20BE",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2011; 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.