Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Nicholas Staub

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1790274066

Nicholas Staub is a Podiatry in Richfield, Minnesota. Graduated from Des Moines University of Osteopathic Medicine and Health Sciences in 2018, 8 years ago. Practices with Active Feet, Foot and Ankle Health Center, an 18-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
8
Trained at
Des Moines University of Osteopathic Medicine and Health Sciences
Licensed in
MN
In the registry since
2018
Specialties on file
2

Practice location Address checks out

6625 Lyndale Ave S Ste 105
Richfield, MN 55423-2673
Phone: (612) 200-8029
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 12303 De Paul Dr, Bridgeton, MO 63044-2512 — (314) 344-7545

Specialties & licences

Podiatrist (primary) Taxonomy 213E00000X · Licence 1091 (MN)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1790274066
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMay 2, 2018
Last updated in NPPESAugust 23, 2021
Certification dateAugust 23, 2021
Mailing address6625 Lyndale Ave S Ste 300, Richfield, MN 55423-2491

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPODIATRY
Medical schoolDES MOINES UNIVERSITY OF OSTEOPATHIC MEDICINE AND HEALTH SCIENCES
Graduated 2018 (8 years in practice)
Group practice Active Feet, Foot And Ankle Health Center — 18 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Richfield