Nathan A Moldestad, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

7907 Issued in MN

Practice address

200 8TH Ave NW
Suite 4
Faribault, MN 55021-5068

Phone

(507) 334-5627

Fax

(507) 334-1824

NPI assigned

Jun 11, 2007

Last updated

Jul 12, 2007By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Back in Action Rehab LLPGroup PAC ID 3678463098, 3 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Back in Action Rehab, LLP

  • Occupational Therapist
  • Faribault, MN
  • NPI 1699848143
  Medicare reassignment Care Compare group
• Dr. Robert J. Erickson, P.a.

  • Chiropractor
  • Faribault, MN
  • NPI 1437290186
  NPD
• Knewtson Family Chiropractic PA

  • Chiropractor
  • Excelsior, MN
  • NPI 1477589109
  NPD (past)

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184198400000",
    "number": "1174726632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 8TH AVE NW",
            "address_2": "SUITE 4",
            "city": "FARIBAULT",
            "state": "MN",
            "postal_code": "550215068",
            "telephone_number": "507-334-5627",
            "fax_number": "507-334-1824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 8TH AVE NW",
            "address_2": "SUITE 4",
            "city": "FARIBAULT",
            "state": "MN",
            "postal_code": "550215068",
            "telephone_number": "507-334-5627",
            "fax_number": "507-334-1824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLDESTAD",
        "first_name": "NATHAN",
        "middle_name": "A",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-11",
        "last_updated": "2007-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "7907",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN BLUE CROSS BLUE SHIELD",
            "identifier": "230D7MO",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ibtisam Mohamed
• Kowsar Mohamed
• Maria Adan Mohamed
• Najma Mohamed
• Kin J Mohamud
• Shawna Molloy, BCBA
• James Layne Moore, MD
• Msocs-Shumway
• Michael Jeffrey Muehlenbein, CRNA
• Clinton Arthur Muench, M.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2007; 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.