Individual provider Active NPI

Grant Phillip Haugen

  • Physical Therapist
  • Alexandria, MN
National Provider Identifier
1285298349
Registry record updated Jul 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
10383 Issued in MN
Practice address
1527 Broadway St
Alexandria, MN 56308-2537
Phone
(320) 762-0399
NPI assigned
Apr 24, 2019
Last updated
Jul 29, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2022

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 10383 MN Primary

Addresses

Primary practice location

1527 Broadway St
Alexandria, MN 56308-2537

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074

Other practice location 1

212 W Soo St
Parkers Prairie, MN 56361-4404
Phone (218) 338-1014

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201105000717 MN Practitioner - Physical Therapist in Private Practice 0244640084 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
82.73 of 100Reported as group
Quality
71.75
Promoting interoperability
100
Improvement activities
40
Cost
70.68

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Astera Health CurrentSince Sep 30, 2024 Accepting new patients
Astera Health Physical Therapist CurrentSince Sep 30, 2024 Accepting new patients

Locations

415 Jefferson St N
Wadena, MN 56482
Phone (218) 631-3510

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1556064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659052800000",
    "number": "1285298349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1527 BROADWAY ST",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563082537",
            "telephone_number": "320-762-0399"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "212 W Soo St",
            "address_purpose": "LOCATION",
            "city": "Parkers Prairie",
            "state": "MN",
            "postal_code": "563614404",
            "country_code": "US",
            "telephone_number": "218-338-1014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAUGEN",
        "first_name": "GRANT",
        "middle_name": "PHILLIP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-24",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "10383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2022; 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.