Individual provider Active NPI

Steven Llewellyn Poissant, PT.,L., AC.,C.S.C.S

  • Physical Therapist
  • Fertile, MN
National Provider Identifier
1053367029
Registry record updated Jun 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3093 Issued in MN
Practice address
208 N Mill St
Fertile, MN 56540-4328
Phone
(218) 945-3409
Fax
(218) 945-3588
NPI assigned
May 25, 2006
Last updated
Jun 20, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 1080 MN
Physical Therapist 225100000X 3093 MN Primary

Addresses

Primary practice location

208 N Mill St
Fertile, MN 56540-4328

Mailing address

208 N Mill St
Fertile, MN 56540-4328
Phone (218) 945-3409

Other practice location 1

323 S Minnesota St
Crookston, MN 56716-1601
Phone (218) 281-9222

Other practice location 2

101 S Mill St
Fertile, MN 56540
Phone (218) 945-5620

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050217000798 MN Practitioner - Physical Therapist in Private Practice 9032161013 Reassigns benefits to 1 organization
Practice locations: Fertile, MN

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverview Healthcare AssociationGroup PAC ID 7810806718, 46 clinicians

Practice addresses (Care Compare)

101 S Mill St
Fertile, MN 56540-4330
Phone (218) 281-9200

Merit-based Incentive Payment System (MIPS)

Final score
88.91 of 100Reported as group
Quality
88.07
Promoting interoperability
100
Improvement activities
40
Cost
74.95

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1080MNMDAcupuncturist
3093MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Riverview Healthcare Association Current Accepting new patients
Riverview Healthcare Association CurrentSince Oct 1, 2021 Accepting new patients
Riverview Healthcare Association CurrentSince Oct 1, 2021 Accepting new patients

Locations

323 S Minnesota St
Crookston, MN 56716
Phone (218) 281-9200

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655683200000",
    "number": "1053367029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 N MILL ST",
            "city": "FERTILE",
            "state": "MN",
            "postal_code": "565404328",
            "telephone_number": "218-945-3409",
            "fax_number": "218-945-3588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 N MILL ST",
            "city": "FERTILE",
            "state": "MN",
            "postal_code": "565404328",
            "telephone_number": "218-945-3409",
            "fax_number": "218-945-3588"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "323 S Minnesota St",
            "address_purpose": "LOCATION",
            "city": "Crookston",
            "state": "MN",
            "postal_code": "567161601",
            "country_code": "US",
            "telephone_number": "218-281-9222",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 S Mill St",
            "address_purpose": "LOCATION",
            "city": "Fertile",
            "state": "MN",
            "postal_code": "56540",
            "country_code": "US",
            "telephone_number": "218-945-5620",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POISSANT",
        "first_name": "STEVEN",
        "middle_name": "LLEWELLYN",
        "name_prefix": "Mr.",
        "credential": "PT.,L., AC.,C.S.C.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "MN",
            "license": "1080",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "3093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fertile, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2022; 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.