Individual provider Active NPI

Mara Ann Boonstra, PT, DPT

  • Physical Therapist
  • Minnetonka, MN
National Provider Identifier
1235081332
Registry record updated Feb 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
14234 Issued in MN
Practice address
15111 Twelve Oaks Center Dr
Minnetonka, MN 55305-5201
Phone
(952) 993-5900
NPI assigned
Feb 11, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2026

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 14234 MN Primary

Addresses

Primary practice location

15111 Twelve Oaks Center Dr
Minnetonka, MN 55305-5201

Mailing address

710 Weston Ridge Pkwy
Chaska, MN 55318-1202

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260316000348 MN Practitioner - Physical Therapist in Private Practice 8426531732 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Park Nicollet ClinicGroup PAC ID 7911819438, 1,778 clinicians

Practice addresses (Care Compare)

15111 Twelve Oaks Ctr Dr
Minnetonka, MN 55305-5201
Phone (952) 993-4500

5320 Hyland Greens Dr
Bloomington, MN 55437-3934
Phone (952) 993-2400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14234MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Park Nicollet Clinic CurrentSince Feb 16, 2026 Accepting new patients
Tria Orthopaedic Center LLC Physical Therapist CurrentSince Feb 16, 2026 Accepting new patients

Locations

15111 Twelve Oaks Center Dr
Minnetonka, MN 55305
Phone (952) 993-4500

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": "1770768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770768000000",
    "number": "1235081332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 WESTON RIDGE PKWY",
            "city": "CHASKA",
            "state": "MN",
            "postal_code": "553181202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15111 TWELVE OAKS CENTER DR",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553055201",
            "telephone_number": "952-993-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOONSTRA",
        "first_name": "MARA",
        "middle_name": "ANN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-02-11",
        "last_updated": "2026-02-11",
        "certification_date": "2026-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "14234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minnetonka, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2026; 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.