Individual provider Active NPI

Jaclyn A Riley, PT

  • Physical Therapist
  • Saint Paul, MN
National Provider Identifier
1093807299
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
7830 Issued in MN
Practice address
2334 University Ave W
Suite 170
Saint Paul, MN 55114-1858
Phone
(651) 645-8083
Fax
(651) 645-8078
NPI assigned
Sep 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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 7830 MN Primary

Addresses

Primary practice location

2334 University Ave W
Suite 170
Saint Paul, MN 55114-1858

Mailing address

7581 9TH St N
Suite 100
Oakdale, MN 55128-6626
Phone (651) 747-4328

Other names 1

  • Jaclyn A Sames Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061010000400 MN Practitioner - Physical Therapist in Private Practice 3870599178 Reassigns benefits to 2 organizations

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
Tria Orthopaedic Center LLCGroup PAC ID 3173570561, 504 clinicians

Practice addresses (Care Compare)

8100 Northland Dr
Bloomington, MN 55431-4800
Phone (952) 831-8742

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7830MNMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy Partners, Inc. Physical Therapist Current Accepting new patients
Tria Orthopaedic Center LLC Physical Therapist CurrentSince Oct 18, 2024 Accepting new patients
Therapy Partners Inc Physical Therapist Past Accepting new patients
Saunders Therapy Centers Inc Physical Therapist PastSince Mar 1, 2009 Accepting new patients

Locations

8100 Northland Dr
Minneapolis, MN 55431
Phone (952) 831-1626

7581 9th St N
Ste 100
Saint Paul, MN 55128

1939 Minnehaha Ave W
Ste 300
Saint Paul, MN 55104

1700 Saint Francis Ave
Shakopee, MN 55379
Phone (952) 993-7800

1700 Tower Dr W
Stillwater, MN 55082
Phone (651) 275-4706

Organizations & group practices 4

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": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1093807299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7581 9TH ST N",
            "address_2": "SUITE 100",
            "city": "OAKDALE",
            "state": "MN",
            "postal_code": "551286626",
            "telephone_number": "651-747-4328",
            "fax_number": "651-748-2892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2334 UNIVERSITY AVE W",
            "address_2": "SUITE 170",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141858",
            "telephone_number": "651-645-8083",
            "fax_number": "651-645-8078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RILEY",
        "first_name": "JACLYN",
        "middle_name": "A",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "7830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACLYN",
            "last_name": "SAMES",
            "middle_name": "A",
            "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 Nov 12, 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.