Active NPI
Robert J Herdzina, PT
- Physical Therapist
- Vadnais Heights, MN
National Provider Identifier
1003072562
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 8153
- Practice address
- 3580 Arcade St Ste 150
Vadnais Heights, MN 55127-7135 - Phone
- (651) 968-5201
- NPI assigned
- Aug 4, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 8153 | MN | Primary |
Addresses
Primary practice location
3580 Arcade St Ste 150
Vadnais Heights, MN 55127-7135
Mailing address
3580 Arcade St Ste 150
Vadnais Heights, MN 55127-7135
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8153 | MN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Summit Orthopedics, LTD | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Orthopaedic Surgery Physician
- Woodbury, MN
- NPI 1306899463
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217808000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1503964800000",
"number": "1003072562",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3580 ARCADE ST STE 150",
"city": "VADNAIS HEIGHTS",
"state": "MN",
"postal_code": "551277135"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3580 ARCADE ST STE 150",
"city": "VADNAIS HEIGHTS",
"state": "MN",
"postal_code": "551277135",
"telephone_number": "651-968-5201"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERDZINA",
"first_name": "ROBERT",
"middle_name": "J",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-08-04",
"last_updated": "2017-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MN",
"license": "8153",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vadnais Heights, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2017; 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.