Individual provider Active NPI

Brett Black, PT, DPT

  • Physical Therapist
  • Rosemount, MN
National Provider Identifier
1124619713
Registry record updated Apr 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11968 Issued in MN
Practice address
14450 S Robert TRL Ste 208
Rosemount, MN 55068-4952
Phone
(651) 423-2251
NPI assigned
Jan 27, 2021
Last updated
Apr 9, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2026

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 11968 MN Primary

Addresses

Primary practice location

14450 S Robert TRL Ste 208
Rosemount, MN 55068-4952

Mailing address

14450 S Robert TRL Ste 208
Rosemount, MN 55068-4952
Phone (651) 423-2251

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210831002789 MN Practitioner - Physical Therapist in Private Practice 8224434204 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nielson Family Chiropractic LLCGroup PAC ID 0648446930, 9 clinicians

Practice addresses (Care Compare)

14450 S Robert TRL
Suite 208
Rosemount, MN 55068-4952
Phone (651) 423-2251

5050 W 36TH St
Suite 100
St Louis Park, MN 55416-5470
Phone (952) 925-4085

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy Consultants, Inc. PastSince Jan 1, 2021 Accepting new patients

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, 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": "1611705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775692800000",
    "number": "1124619713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14450 S ROBERT TRL STE 208",
            "city": "ROSEMOUNT",
            "state": "MN",
            "postal_code": "550684952",
            "telephone_number": "651-423-2251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14450 S ROBERT TRL STE 208",
            "city": "ROSEMOUNT",
            "state": "MN",
            "postal_code": "550684952",
            "telephone_number": "651-423-2251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "BRETT",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-27",
        "last_updated": "2026-04-09",
        "certification_date": "2026-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "11968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rosemount, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2026; 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.