Michael Charles Lofboom

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11449 Issued in MN

Practice address

155 Radio Dr
Woodbury, MN 55125-2619

Phone

(952) 831-8742

NPI assigned

Jun 10, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tria Orthopaedic Center LLC 504 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Tria Orthopaedic Center LLC

  • Orthopaedic Surgery Physician
  • Bloomington, MN
  • NPI 1518273085

  MN, Physical Therapist

  Medicare reassignment Care Compare group NPD
• Tria Orthopaedic Center LLC

  • Ambulatory Surgical Clinic/Center
  • Minneapolis, MN
  • NPI 1053314013
  Care Compare group
• Tria Orthopaedic Center LLC

  • Certified Registered Nurse Anesthetist
  • Minneapolis, MN
  • NPI 1053483503
  Care Compare group
• Tria Orthopaedic Center LLC

  • Orthopaedic Surgery Physician
  • Bloomington, MN
  • NPI 1346624384

  Physical Therapist

  NPD

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

{
    "created_epoch": "1560124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563321600000",
    "number": "1124687546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7540 N 19TH AVE STE 200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850217967",
            "telephone_number": "888-873-4221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 RADIO DR",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252619",
            "telephone_number": "952-831-8742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOFBOOM",
        "first_name": "MICHAEL",
        "middle_name": "CHARLES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-10",
        "last_updated": "2019-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "11449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John D Liveringhouse, MD
• LNG Landscapes
• Roxanne E Lockhart, MD
• Miranda Lockner
• Sara Loenser, PHARMD
• Valerie Loftus, RD, LD
• Tamara Beer Long, PT
• Theresa Lonsky, O.D.
• Melissa Renne Lopez
• Stephanie Ellen Lopez, MA, BCBA, LBA

• All providers in Woodbury, MN
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2019; 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.