Henry Byl

Individual provider Active NPI Physical Therapist · North Mankato, MN

NPI 1003276908 · NPPES record last updated Mar 4, 2016

Key facts

NPI
1003276908
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
10212 (MN)
Practice address
1681 Commerce Dr
North Mankato, MN 56003-1913
Phone
(507) 625-8017
NPI assigned
Mar 4, 2016
Sex
Male
Sole proprietor
No

Organizations & group practices 1

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.

Medicare Care Compare profile

Specialty
Physical Therapist in Private Practice
Education
University of Iowa, RJ & L Carver College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Proactive Physical Therapy and Sports Rehab, Inc (10 clinicians)

Practice addresses (Care Compare)

110 16TH St SW
Sioux Center, IA 51250-2944
Phone (712) 722-1902

1717 N Prairie View Cir
Sioux Center, IA 51250-7604

301 10TH St
Suite C
Sheldon, IA 51201-1509
Phone (712) 324-0110

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20180815003331 IA Practitioner - Physical Therapist in Private Practice 0547566549 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
10212MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Proactive Physical Therapy & Sports Rehab, Inc Physical Therapist Current
since Jul 1, 2018
Accepting new patients

Locations

301 10th St
Ste C
Sheldon, IA 51201
Phone (712) 324-0110

110 16th St SW
Sioux Center, IA 51250
Phone (712) 722-1902

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 10212 MN Yes

Addresses

Primary practice location

1681 Commerce Dr
North Mankato, MN 56003-1913

Mailing address

7551 9TH St N
Suite 100
Oakdale, MN 55128-6629
Phone (651) 748-4338

Other providers in North Mankato, MN

All providers in North Mankato, MN · Physical Therapist in Minnesota

Sources for this page

Verify at the official NPI Registry.