Individual provider Active NPI

Jake Portinga, MED

  • Sports Physical Therapist
  • Chaska, MN
National Provider Identifier
1336076413
Registry record updated May 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physical TherapistTaxonomy code 2251S0007X
Practice address
111 Hundertmark Rd
Chaska, MN 55318-4551
Phone
(952) 361-2447
NPI assigned
May 5, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physical Therapist 2251S0007X MN Primary

Addresses

Primary practice location

111 Hundertmark Rd
Chaska, MN 55318-4551

Mailing address

5828 Meadow Lake Rd W
New Hope, MN 55428-3169
Phone (952) 381-7565

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)
Not enrolled
Credentials
Master of Education

NPI Registry JSON

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

{
    "created_epoch": "1777939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777939200000",
    "number": "1336076413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5828 MEADOW LAKE RD W",
            "city": "NEW HOPE",
            "state": "MN",
            "postal_code": "554283169",
            "telephone_number": "952-381-7565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 HUNDERTMARK RD",
            "city": "CHASKA",
            "state": "MN",
            "postal_code": "553184551",
            "telephone_number": "952-361-2447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTINGA",
        "first_name": "JAKE",
        "credential": "MED",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-05-05",
        "last_updated": "2026-05-05",
        "certification_date": "2026-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chaska, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.