Individual provider Active NPI

Thomas Leonard Dahl II, P.T.

  • Physical Therapist
  • Plymouth, MN
National Provider Identifier
1184642373
Registry record updated Aug 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
20878 Issued in FL
Practice address
15700 37TH Ave N Ste 220
Plymouth, MN 55446
Phone
(651) 968-5201
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2018

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 20878 FL Primary

Addresses

Primary practice location

15700 37TH Ave N Ste 220
Plymouth, MN 55446

Mailing address

15700 37TH Ave N Ste 220
Plymouth, MN 55446-3399
Phone (651) 968-5201

Other identifiers 1

IdentifierTypeStateIssuer
1184642373OtherFLCIGNA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181018001743 MN Practitioner - Physical Therapist in Private Practice 1759484413 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Orthopedics, LTDGroup PAC ID 8921900374, 282 clinicians

Practice addresses (Care Compare)

15700 37TH Ave N
Suite 150
Plymouth, MN 55446-3675
Phone (651) 968-5201

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20878FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Orthopedics, LTD CurrentSince Sep 4, 2018 Accepting new patients
Summit Orthopedics LTD CurrentSince Sep 4, 2018 Accepting new patients

Locations

15700 37th Ave N
Ste 220
Plymouth, MN 55446
Phone (651) 968-5600

6050 Sycamore Ln N
Plymouth, MN 55442
Phone (651) 968-5462

15700 37th Ave N
Ste 150
Plymouth, MN 55446
Phone (651) 968-1627

2620 Eagan Woods Dr
Saint Paul, MN 55121
Phone (651) 968-5142

1661 Saint Anthony Ave
Saint Paul, MN 55104
Phone (651) 968-5300

3580 Arcade St
Vadnais Heights, MN 55127
Phone (651) 968-5600

2090 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 968-5801

710 Commerce Dr
Ste 200
Woodbury, MN 55125
Phone (651) 968-5042

Organizations & group practices 2

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534982400000",
    "number": "1184642373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15700 37TH AVE N STE 220",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554463399",
            "telephone_number": "651-968-5201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15700 37TH AVE N STE 220",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "55446",
            "telephone_number": "651-968-5201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHL",
        "first_name": "THOMAS",
        "middle_name": "LEONARD",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2018-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "20878",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1184642373",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2018; 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.