Lori L Sandberg, PT

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

License

7024 Issued in MN

Practice address

3475 Plymouth Blvd Ste 200
Plymouth, MN 55447-1539

Phone

(763) 577-2484

NPI assigned

Oct 15, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Minnesota Head and Neck Pain Clinic PAGroup PAC ID 2769453687, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.72099
• Direct secure messaging: lori.schaar.1@13597.direct.athenahealth.com

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.

• Minnesota Head and Neck Pain Clinic, PA

  • Specialist
  • St Paul, MN
  • NPI 1104850155
  Medicare reassignment Care Compare group
• Minnesota Spine Rehab, Inc

  • Occupational Medicine Clinic/Center
  • Saint Paul, MN
  • NPI 1043236896
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1192406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1043409170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3475 PLYMOUTH BLVD STE 200",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554471539",
            "telephone_number": "763-577-2484",
            "fax_number": "763-577-1375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3475 PLYMOUTH BLVD STE 200",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554471539",
            "telephone_number": "763-577-2484"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2550 University Ave W",
            "address_2": "Suite 189S",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551141052",
            "country_code": "US",
            "telephone_number": "651-332-7470",
            "fax_number": "651-332-7490",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDBERG",
        "first_name": "LORI",
        "middle_name": "L",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-15",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "MN",
            "license": "7024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELF MN",
            "identifier": "27OL4BO",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela Salue
• Mary Kathleen Salveson, OCCUPATIONAL THERAPI
• Emily Samborn, NP
• Steven Andrew Samborski, M.D.
• Anita Sampson
• Ayanna Adriana Sanders
• Vakia Nicole Sandifer
• Jeffrey David Sandquist, PA-C
• Edward Rainier Gamboa Santos, MD
• James Sarkor, LPN

• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Plymouth, MN
• Providers in Plymouth, MN by specialty
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.