Active NPI
Joshua Mistic, DPT
- Physical Therapist
- Bemidji, MN
National Provider Identifier
1245509876
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 9181
- Practice address
- 1217 Anne St NW
Bemidji, MN 56601-5113 - Phone
- (218) 755-6360
- Fax
- (218) 755-6399
- NPI assigned
- Dec 28, 2011
- Reactivated
- Sep 29, 2022
- Last updated
- Dec 8, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 9181 | MN | Primary |
Addresses
Primary practice location
1217 Anne St NW
Bemidji, MN 56601-5113
Mailing address
1217 Anne St NW
Bemidji, MN 56601-5113
Phone (218) 755-6360
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 070018894 | Other | IL | STATE LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9181 | MN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brefeld Physical Therapy Services PC | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Therapist
- Belleville, IL
- NPI 1053308015
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1325030400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1765152000000",
"number": "1245509876",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1217 ANNE ST NW",
"city": "BEMIDJI",
"state": "MN",
"postal_code": "566015113",
"telephone_number": "218-755-6360",
"fax_number": "218-755-6399"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1217 ANNE ST NW",
"city": "BEMIDJI",
"state": "MN",
"postal_code": "566015113",
"telephone_number": "218-755-6360",
"fax_number": "218-755-6399"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MISTIC",
"first_name": "JOSHUA",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-12-28",
"last_updated": "2025-12-08",
"certification_date": "2025-12-08",
"deactivation_date": "2019-09-22",
"reactivation_date": "2022-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MN",
"license": "9181",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "070018894",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bemidji, MN
- Mark A Miller, LMFT
- Thomas E Miller, M.D.
- Judith A Mills, D.O.
- Minnesota State Colleges and Universities (Bemidji State University Student Center for Health and Counseling)
- Mississippi Headwaters Area Dental Health Center, Inc.
- Amanda Mlaker, MSW, LICSW, LADC
- MN Lakers Transportation, LLC
- Anna Marie Mock
- Lindsey Rae Moe, LPCC
- Kristy Lynn Moen, REGISTERED NURSE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.