Active NPI
Melanie K Youngquist, PT
- Physical Therapist
- White Bear Lake, MN
National Provider Identifier
1033207014
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 6355
- Practice address
- 4800 White Bear Pkwy
White Bear Lake, MN 55110-3345 - Phone
- (651) 426-3800
- NPI assigned
- Oct 11, 2006
- Sex
- Female
- 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 | 6355 | MN | Primary |
Addresses
Primary practice location
4800 White Bear Pkwy
White Bear Lake, MN 55110-3345
Mailing address
2399 Ariel St N
Suite B
Maplewood, MN 55109-2203
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7152222100 | Medicaid | MN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6355 | MN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Therapy Partners, Inc | Physical Therapist | Past | Accepting new patients |
| Therapy Partners, Ins | Physical Therapist | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1033207014",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2399 ARIEL ST N",
"address_2": "SUITE B",
"city": "MAPLEWOOD",
"state": "MN",
"postal_code": "551092203"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4800 WHITE BEAR PKWY",
"city": "WHITE BEAR LAKE",
"state": "MN",
"postal_code": "551103345",
"telephone_number": "651-426-3800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNGQUIST",
"first_name": "MELANIE",
"middle_name": "K",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MN",
"license": "6355",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7152222100",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in White Bear Lake, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.