Individual provider Active NPI

Rachael L Ottum, DPT

  • Physical Therapist
  • Saint Paul, MN
National Provider Identifier
1043643505
Registry record updated Aug 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
9400 Issued in MN
Practice address
1015 Sibley Memorial Hwy Apt 232
Saint Paul, MN 55118-5601
Phone
(651) 492-1293
NPI assigned
Aug 19, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 9400 MN Primary

Addresses

Primary practice location

1015 Sibley Memorial Hwy Apt 232
Saint Paul, MN 55118-5601

Mailing address

1015 Sibley Memorial Hwy Apt 232
Saint Paul, MN 55118-5601
Phone (651) 492-1293

Other names 1

  • Rachael L Olson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150514002502 MN Practitioner - Physical Therapist in Private Practice 0042530081 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Infinite Health Collaborative, PAGroup PAC ID 1052225042, 815 clinicians

Practice addresses (Care Compare)

2700 Vikings Cir
Eagan, MN 55121-1002
Phone (952) 456-7600

Merit-based Incentive Payment System (MIPS)

Final score
91.79 of 100Reported as group
Quality
95.08
Improvement activities
40
Cost
81.67

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Infinite Health Collaborative, PA Physical Therapist CurrentSince Apr 26, 2021 Accepting new patients
Infinite Health Collaborative, PA CurrentSince Apr 26, 2021 Accepting new patients

Locations

2700 Vikings Cir
Eagan, MN 55121
Phone (952) 456-7600

920 E 28th St
Ste 440
Minneapolis, MN 55407
Phone (612) 863-5155

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": "1376870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408924800000",
    "number": "1043643505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 SIBLEY MEMORIAL HWY APT 232",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551185601",
            "telephone_number": "651-492-1293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 SIBLEY MEMORIAL HWY APT 232",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551185601",
            "telephone_number": "651-492-1293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTUM",
        "first_name": "RACHAEL",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-19",
        "last_updated": "2014-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "9400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RACHAEL",
            "last_name": "OLSON",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2014; 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.