Kelsey Nowak, PT
Individual provider Active NPI Physical Therapist · Glencoe, MN
NPI 1134526650 · NPPES record last updated Nov 26, 2014
Key facts
- NPI
- 1134526650
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 8167 (MN)
- Practice address
- 1805 Hennepin Ave N
Glencoe, MN 55336-1416 - Phone
- (320) 864-3121
- NPI assigned
- Nov 26, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
Merit-based Incentive Payment System (MIPS)
- Final score
- 91.79 of 100
- Quality
- 95.08
- Improvement activities
- 40
- Cost
- 81.67
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220330002339 | MN | Practitioner - Physical Therapist in Private Practice | 8820484819 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8167 | MN | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kandor Physical Therapy & Pelvic Health LLC | Current | Accepting new patients | |
| Infinite Health Collaborative, PA | Physical Therapist | Current |
Accepting new patients |
| Infinite Health Collaborative, PA | Current |
Accepting new patients |
Locations
1805 Hennepin Ave N
Glencoe, MN 55336
Phone (320) 864-3121
920 E 28th St
Ste 440
Minneapolis, MN 55407
Phone (612) 863-5155
4200 Dahlberg Dr
Ste 300
Minneapolis, MN 55422
Phone (952) 512-5600
820 Village Way
Ste 100
Waconia, MN 55387
Phone (952) 927-2960
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 8167 | MN | Yes |
Addresses
Primary practice location
1805 Hennepin Ave N
Glencoe, MN 55336-1416
Mailing address
1805 Hennepin Ave N
Glencoe, MN 55336-1416
Phone (320) 864-3121
NPI Registry JSON
{
"created_epoch": "1416960000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1416960000000",
"number": "1134526650",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1805 HENNEPIN AVE N",
"city": "GLENCOE",
"state": "MN",
"postal_code": "553361416",
"telephone_number": "320-864-3121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1805 HENNEPIN AVE N",
"city": "GLENCOE",
"state": "MN",
"postal_code": "553361416",
"telephone_number": "320-864-3121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOWAK",
"first_name": "KELSEY",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-11-26",
"last_updated": "2014-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MN",
"license": "8167",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glencoe, MN
- Dale E Nelson
- Merrill D Nelson
- Arthur Niemela
- Synnove Nieuwenhuis
- Northland Hearing Centers, Inc.
- Barbara Oberlin
- Brent Willard Olson
- Laura Jean Olson
- On-Site Podiatry, Inc
- John Ostby
All providers in Glencoe, MN · Physical Therapist in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 26, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.