Individual provider Active NPI

Rebecca Mae Gilbertson, PT

  • Physical Therapist
  • Roseville, MN
National Provider Identifier
1073734976
Registry record updated Oct 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8857 Issued in MN
Practice address
2945 Lincoln Dr
Roseville, MN 55113-1338
Phone
(651) 628-3000
NPI assigned
May 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT9522 CO
Physical Therapist 225100000X 8857 MN Primary

Addresses

Primary practice location

2945 Lincoln Dr
Roseville, MN 55113-1338

Mailing address

1854 20TH Ave NW
New Brighton, MN 55112-5420
Phone (612) 275-4229

Other identifiers 1

IdentifierTypeStateIssuer
UNIV OF WIOtherWIMS PHYSICAL THERAPY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230105002702 MN Practitioner - Physical Therapist in Private Practice 5294105367 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optage IncGroup PAC ID 2264619345, 61 clinicians

Practice addresses (Care Compare)

2945 Lincoln Dr
Roseville, MN 55113-1338
Phone (651) 631-6570

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8857MNMDOrthodontics and Dentofacial Orthopedic Dentist
PT9522COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Optage Inc Physical Therapist CurrentSince Oct 1, 2022 Accepting new patients
Optage Inc Physical Therapist Current Accepting new patients
Optage Inc Physical Therapist CurrentSince Oct 1, 2022 Accepting new patients

Locations

2845 Hamline Ave N
Saint Paul, MN 55113
Phone (651) 631-6100

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665014400000",
    "number": "1073734976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1854 20TH AVE NW",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551125420",
            "telephone_number": "612-275-4229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2945 LINCOLN DR",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551131338",
            "telephone_number": "651-628-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILBERTSON",
        "first_name": "REBECCA",
        "middle_name": "MAE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PT9522",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "8857",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MS PHYSICAL THERAPY",
            "identifier": "UNIV OF WI",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 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.