Individual provider Active NPI

Michael Walsh, DPT, ATC

  • Physical Therapist
  • Rochester, MN
National Provider Identifier
1114468691
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
12299 Issued in MN
Practice address
4229 W Frontage Rd N
Rochester, MN 55901-4310
Phone
(507) 322-3460
NPI assigned
Mar 16, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X
Student in an Organized Health Care Education/Training Program 390200000X
Physical Therapist 225100000X 12299 MN Primary

Addresses

Primary practice location

4229 W Frontage Rd N
Rochester, MN 55901-4310

Mailing address

116 Brownsville St NE
Preston, MN 55965-1127

Other practice location 1

133 St. Paul Street SW
Preston, MN 55965
Phone (507) 322-3460

Other practice location 2

3100 19th St NW Ste 200
Rochester, MN 55901-6606
Phone (507) 322-3460

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210827000649 MN Practitioner - Physical Therapist in Private Practice 6103221262 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Duke University School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Activept, Corp.Group PAC ID 9931279932, 76 clinicians

Practice addresses (Care Compare)

3100 19TH St NW
Suite 200
Rochester, MN 55901-6606
Phone (507) 322-3460

Merit-based Incentive Payment System (MIPS)

Final score
92.09 of 100Reported as group
Quality
96.62
Improvement activities
40
Cost
79.84

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Activept Corp CurrentSince Jun 24, 2021 Accepting new patients
Pursuitpt LLC Physical Therapist PastSince Mar 7, 2021 Accepting new patients

Locations

133 Saint Paul St SW
Preston, MN 55965

3100 19th St NW
Ste 200
Rochester, MN 55901

4229 W Frontage Rd N
Rochester, MN 55901

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": "1489622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1114468691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 BROWNSVILLE ST NE",
            "city": "PRESTON",
            "state": "MN",
            "postal_code": "559651127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4229 W FRONTAGE RD N",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559014310",
            "telephone_number": "507-322-3460"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "133 St. Paul Street SW",
            "address_purpose": "LOCATION",
            "city": "Preston",
            "state": "MN",
            "postal_code": "55965",
            "country_code": "US",
            "telephone_number": "507-322-3460",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3100 19th St NW Ste 200",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MN",
            "postal_code": "559016606",
            "country_code": "US",
            "telephone_number": "507-322-3460",
            "fax_number": "507-322-3450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALSH",
        "first_name": "MICHAEL",
        "credential": "DPT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-16",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "12299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 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.