Individual provider Active NPI

Tamara L Kobienia, PHYSICAL THERAPIST

  • Physical Therapist
  • Willmar, MN
National Provider Identifier
1164586780
Registry record updated Feb 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5761 Issued in MN
Practice address
2800 1St St S Ste 110
Willmar, MN 56201-4271
Phone
(320) 318-8812
Fax
(320) 318-8813
NPI assigned
Dec 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2022

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 5761 MN Primary

Addresses

Primary practice location

2800 1St St S Ste 110
Willmar, MN 56201-4271

Mailing address

2800 1St St S Ste 110
Willmar, MN 56201-4271
Phone (203) 318-8812

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120305000167 MN Practitioner - Physical Therapist in Private Practice 0749449148 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2800 1St St S
Suite 110
Willmar, MN 56201-4271
Phone (320) 318-8812

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
5761MNMDRegistered Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Transcend Rehab & Wellness LLC CurrentSince May 10, 2019 Accepting new patients

Locations

2800 1st St S
Ste 110
Willmar, MN 56201
Phone (320) 318-8812

Organizations & group practices 1

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": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643932800000",
    "number": "1164586780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 1ST ST S STE 110",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562014271",
            "telephone_number": "203-318-8812",
            "fax_number": "320-318-8813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 1ST ST S STE 110",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562014271",
            "telephone_number": "320-318-8812",
            "fax_number": "320-318-8813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOBIENIA",
        "first_name": "TAMARA",
        "middle_name": "L",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-20",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "5761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willmar, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2022; 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.