Individual provider Active NPI

Gregory Michael Deyak, PT

  • Physical Therapist
  • Oak Park Heights, MN
National Provider Identifier
1255783999
Registry record updated Jul 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5818 Issued in MN
Practice address
5805 Neal Ave N
Oak Park Heights, MN 55082-2177
Phone
(651) 439-8807
Fax
(651) 439-0232
NPI assigned
Jul 6, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2016

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 5818 MN Primary

Addresses

Primary practice location

5805 Neal Ave N
Oak Park Heights, MN 55082-2177

Mailing address

5805 Neal Ave N
Oak Park Heights, MN 55082-2177
Phone (651) 439-8807

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160810001216 MN Practitioner - Physical Therapist in Private Practice 9739473968 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Infinite Health Collaborative, PAGroup PAC ID 1052225042, 815 clinicians

Practice addresses (Care Compare)

3111 124TH Ave NW
Suite 200
Coon Rapids, MN 55433-4573
Phone (763) 427-7300

4040 Radio Dr
Woodbury, MN 55129-3237
Phone (651) 439-8807

Merit-based Incentive Payment System (MIPS)

Final score
91.79 of 100Reported as group
Quality
95.08
Improvement activities
40
Cost
81.67

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5818MNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Infinite Health Collaborative, PA Physical Therapist CurrentSince Jul 25, 2016 Accepting new patients
Infinite Health Collaborative, PA CurrentSince Jul 25, 2016 Accepting new patients
Infinite Health Collaborative, PA Past Accepting new patients

Locations

920 E 28th St
Ste 440
Minneapolis, MN 55407
Phone (612) 863-5155

5805 Neal Ave N
Oak Park Heights, MN 55082

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": "1467763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467763200000",
    "number": "1255783999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5805 NEAL AVE N",
            "city": "OAK PARK HEIGHTS",
            "state": "MN",
            "postal_code": "550822177",
            "telephone_number": "651-439-8807",
            "fax_number": "651-439-0232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5805 NEAL AVE N",
            "city": "OAK PARK HEIGHTS",
            "state": "MN",
            "postal_code": "550822177",
            "telephone_number": "651-439-8807",
            "fax_number": "651-439-0232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEYAK",
        "first_name": "GREGORY",
        "middle_name": "MICHAEL",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-06",
        "last_updated": "2016-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "5818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park Heights, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 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.