Individual provider Active NPI

Blake R Huppert, DPT

  • Physical Therapist
  • Eagan, MN
National Provider Identifier
1114494606
Registry record updated Nov 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11368 Issued in MN
Practice address
2700 Vikings Cir
Eagan, MN 55121-1002
Phone
(952) 456-7600
Fax
(952) 456-7601
NPI assigned
Nov 1, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2018

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 11368 MN Primary

Addresses

Primary practice location

2700 Vikings Cir
Eagan, MN 55121-1002

Mailing address

4200 Dahlberg Dr Ste 300
Golden Valley, MN 55422-4841
Phone (952) 512-5600

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181208000455 MN Practitioner - Physical Therapist in Private Practice 4183968761 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
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 CurrentSince Nov 12, 2018 Accepting new patients
Infinite Health Collaborative, PA Physical Therapist CurrentSince Nov 12, 2018 Accepting new patients
St. Croix Orthopaedics, PA Past Accepting new patients
Infinite Health Collaborative, PA Past Accepting new patients

Locations

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

4200 Dahlberg Dr
Ste 300
Minneapolis, MN 55422
Phone (952) 512-5600

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

2645 Vikings Cir
Saint Paul, MN 55121
Phone (952) 456-7600

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": "1541030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541030400000",
    "number": "1114494606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 DAHLBERG DR STE 300",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224841",
            "telephone_number": "952-512-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 VIKINGS CIR",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551211002",
            "telephone_number": "952-456-7600",
            "fax_number": "952-456-7601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUPPERT",
        "first_name": "BLAKE",
        "middle_name": "R",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-01",
        "last_updated": "2018-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "11368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2018; 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.