Individual provider Active NPI

Tatia J Moller, PT

  • Orthopedic Physical Therapist
  • Woodbury, MN
National Provider Identifier
1194198598
Registry record updated Oct 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
9732 Issued in MN
Practice address
710 Commerce Dr Ste 200
Woodbury, MN 55125-4925
Phone
(651) 968-5042
Fax
(651) 968-5904
NPI assigned
Nov 6, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 9732 MN Primary

Addresses

Primary practice location

710 Commerce Dr Ste 200
Woodbury, MN 55125-4925

Mailing address

2090 Woodwinds Dr Ste 100
Woodbury, MN 55125-2522
Phone (651) 968-5042

Other names 1

  • Tatia J Nawrocki Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151123000331 MN Practitioner - Physical Therapist in Private Practice 6901106038 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
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)

2090 Woodwinds Dr
Woodbury, MN 55125-2522
Phone (651) 968-5201

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9732MNMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Orthopedics LTD CurrentSince Nov 23, 2015 Accepting new patients
Summit Orthopedics, LTD Orthopedic CurrentSince Nov 23, 2015 Accepting new patients
Summit Orthopedics, LTD. Past Accepting new patients

Locations

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

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

2090 Woodwinds Dr
Ste 100
Woodbury, MN 55125
Phone (651) 968-5600

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

Organizations & group practices 3

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": "1446768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477612800000",
    "number": "1194198598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2090 WOODWINDS DR STE 100",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252522",
            "telephone_number": "651-968-5042",
            "fax_number": "651-968-5042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 COMMERCE DR STE 200",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551254925",
            "telephone_number": "651-968-5042",
            "fax_number": "651-968-5904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLLER",
        "first_name": "TATIA",
        "middle_name": "J",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-06",
        "last_updated": "2016-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MN",
            "license": "9732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TATIA",
            "last_name": "NAWROCKI",
            "middle_name": "J",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Woodbury, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2016; 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.