Hailey Phoulavan, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

14100 Issued in MN

Practice address

60 Marie Ave E Ste 203
West St Paul, MN 55118-5932

Phone

(651) 451-6156

Fax

(651) 451-0387

NPI assigned

Sep 9, 2025

Sex

Unspecified or another gender identity

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Novacare Outpatient Rehabilitation East Inc

  dba NovaCare Rehabilitation

  • Physical Therapy Clinic/Center
  • Fridley, MN
  • NPI 1558610519
  Medicare reassignment
• Novacare Outpatient Rehabilitation East, Inc.

  dba NovaCare Rehabilitation

  • Physical Therapy Clinic/Center
  • Saint Paul, MN
  • NPI 1215556998
  NPD
• Novacare Outpatient Rehabilitation East Inc

  dba NovaCare Rehabilitation

  • Physical Therapy Clinic/Center
  • Ferndale, MI
  • NPI 1245235191
  NPD
• Novacare Outpatient Rehabilitation East Inc

  dba NovaCare Rehabilitation

  • Physical Therapy Clinic/Center
  • Vadnais Heights, MN
  • NPI 1518963909

  Physical Therapist

  NPD (past)
• Select Physical Therapy Holdings Inc

  dba Select Physical Therapy

  • Physical Therapy Clinic/Center
  • Ashland, VA
  • NPI 1174591218
  NPD (past)

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

{
    "created_epoch": "1757376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757376000000",
    "number": "1245111947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "897 REDWELL LN",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551248943",
            "telephone_number": "612-709-1395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 MARIE AVE E STE 203",
            "city": "WEST ST PAUL",
            "state": "MN",
            "postal_code": "551185932",
            "telephone_number": "651-451-6156",
            "fax_number": "651-451-0387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHOULAVAN",
        "first_name": "HAILEY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-09-09",
        "last_updated": "2025-09-09",
        "certification_date": "2025-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "14100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Optometric Services, LLC.
• Emma S Ostby, MD
• Megan Paulsen
• Theresa Joan Pavek
• Phoenix Service Corporation
• Elizabeth Placzek, M.D.
• Natalie E Polak, MS
• Joshua Ponce
• Teresa Ann Puff, MSW, LICSW
• John O Punderson, MD

• Physical Therapist in West St Paul, MN
• Providers in West St Paul, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2025; 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.