HEALTHSOURCE OF MINNETONKA LLC
NPI 1164899795
Chiropractor in Minnetonka, MN
About Healthsource Of Minnetonka Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
HEALTHSOURCE OF MINNETONKA LLC (NPI 1164899795) is a healthcare organization registered as a chiropractor in Minnetonka, Minnesota and active in the NPI registry since August 2015. The organization lists Derek Anderson, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Healthsource Of Minnetonka Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
4Medicare enrollment records show 4 clinicians reassign Medicare billing to Healthsource Of Minnetonka LLC, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 3 within 10 miles. They are listed nearest first.
Clinicians, nearest first (4)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Healthsource Of Minnetonka LLC's NPI number?
The NPI number for Healthsource Of Minnetonka LLC is 1164899795. It was assigned to this organization in the NPPES registry on August 31, 2015.
Where is Healthsource Of Minnetonka LLC located?
Healthsource Of Minnetonka LLC is located at 14413 Excelsior Blvd, Minnetonka, MN 55345. The listed phone number is (952) 746-1506.
What is Healthsource Of Minnetonka LLC's specialty?
The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.
Is Healthsource Of Minnetonka LLC enrolled in Medicare?
Yes. Healthsource Of Minnetonka LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Healthsource Of Minnetonka LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians, all in Chiropractic, reassign their Medicare billing to Healthsource Of Minnetonka LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Healthsource Of Minnetonka LLC accept?
Health plans from HealthPartners list Healthsource Of Minnetonka LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Healthsource Of Minnetonka LLC was last updated on August 31, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Healthsource Of Minnetonka Llc · NPI 1164899795
Chiropractor organization in Minnetonka, Minnesota. Organization record, active in the CMS NPPES registry since August 31, 2015.
## Identity
- **NPI:** 1164899795 (Entity type: Organization)
- **Enumerated:** August 31, 2015
- **Primary specialty:** Chiropractor · taxonomy 111N00000X
- **Organization subpart:** No
- **Authorized official:** Derek Anderson, OWNER
## Practice location
- **Address:** 14413 EXCELSIOR BLVD, Minnetonka, MN 55345-5821
- **Phone:** (952) 746-1506
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 4 clinicians (Chiropractic) reassign Medicare billing to this organization (form CMS-855R); 2 practice at this address and 3 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 31, 2015
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Source: [NPI Profile](https://npiprofile.com/npi/1164899795) · Data from the CMS NPPES public registry.