Alexis Hydukovich, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

7622 Issued in MN

Practice address

11225 Ulysses St NE
Blaine, MN 55434-4261

Phone

(763) 302-2600

Fax

(763) 302-2601

NPI assigned

Dec 9, 2016

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Allina Health System

  • General Acute Care Hospital
  • Buffalo, MN
  • NPI 1538123567
  NPD (past)
• Allina Health System

  • Rheumatology Physician
  • Coon Rapids, MN
  • NPI 1952146516
  NPD (past)
• Infinite Health Collaborative, PA

  • Durable Medical Equipment & Medical Supplies
  • River Falls, WI
  • NPI 1144608589
  NPD (past)

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

{
    "created_epoch": "1481241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1144764150",
    "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": "11225 ULYSSES ST NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554344261",
            "telephone_number": "763-302-2600",
            "fax_number": "763-302-2601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HYDUKOVICH",
        "first_name": "ALEXIS",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-09",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "7622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Timothy Huang, DMD
• Ailsa Rose Huff
• Aki K Hughes-Polk, MS, MA, LPCC,
• Aliyah Mohamed Hussein
• Sumaya Saeed Hussein I
• Esther Idowu
• Ikhlas International Company
• Imagine Smiles
• Infinite Health Collaborative, PA
• Inner Balance Behavioral Health

• Physical Therapist in Blaine, MN
• Providers in Blaine, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.