Nicholas Staub

Primary specialty

PodiatristTaxonomy code 213E00000X

License

1091 Issued in MN

Practice address

6625 Lyndale Ave S Ste 105
Richfield, MN 55423-2673

Phone

(612) 200-8029

NPI assigned

May 2, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Des Moines University of Osteopathic Medicine and Health Sciences, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Active Feet, Foot and Ankle Health CenterGroup PAC ID 1254401300, 18 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Active Feet , Foot & Ankle Health Center

  dba Midwest Podiatry Centers

  • Primary Podiatric Medicine Podiatrist
  • Minneapolis, MN
  • NPI 1689848392
  Medicare reassignment Care Compare group NPD
• In House Senior Services, LLC

  • Primary Podiatric Medicine Podiatrist
  • Richfield, MN
  • NPI 1083962294
  Medicare reassignment NPD
• Active Feet, Foot & Ankle Health Center

  dba Midwest Podiatry Center St. Anthony

  • Foot & Ankle Surgery Podiatrist
  • Minneapolis, MN
  • NPI 1164716387
  NPD

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

{
    "created_epoch": "1525219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629676800000",
    "number": "1790274066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6625 LYNDALE AVE S STE 300",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554232491",
            "telephone_number": "612-788-8778",
            "fax_number": "612-869-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6625 LYNDALE AVE S STE 105",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554232673",
            "telephone_number": "612-200-8029"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12303 De Paul Dr",
            "address_purpose": "LOCATION",
            "city": "Bridgeton",
            "state": "MO",
            "postal_code": "630442512",
            "country_code": "US",
            "telephone_number": "314-344-7545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAUB",
        "first_name": "NICHOLAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-02",
        "last_updated": "2021-08-23",
        "certification_date": "2021-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MN",
            "license": "1091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Lee Speranzella, M.DIV., C.HT.
• Milo Tashi Spivey
• Judith Ann St. Clair, D.C.
• Stability Home Services LLC
• Re Star
• Lisa L Stearns Brown
• Jillian Beth Stearns
• Amanda Jo Steffes, DDS
• Beth A Stegora, PT
• Caroline Louise Stein, PA-C

• Podiatrist in Richfield, MN
• Providers in Richfield, MN by specialty
• Podiatrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.