NPIMap

Organization Active NPI

Novacare Outpatient Rehabilitation East, Inc.

Doing business as NovaCare Rehabilitation

  • Physical Therapy Clinic/Center
  • Maple Grove, MN
National Provider Identifier
1366084402
Registry record updated Sep 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
NOVACARE OUTPATIENT REHABILITATION EAST, INC.
Doing business as
NovaCare Rehabilitation
Practice address
16366 County Road 30
Maple Grove, MN 55311-1207
Phone
(763) 559-0356
Fax
(763) 559-5193
NPI assigned
Oct 10, 2019
Last updated
Sep 26, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
SELECT MEDICALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 26, 2025

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

Authorized official

Name
John F Duggan
Title
Chief Legal Officer
Phone
(717) 972-1100

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary
Rehabilitation Clinic/Center 261QR0400X

Addresses

Primary practice location

16366 County Road 30
Maple Grove, MN 55311-1207

Mailing address

4714 Gettysburg Rd
Mechanicsburg, PA 17055-4325
Phone (717) 972-1100

Other names 1

  • NovaCare Rehabilitation Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20121228000194 MN Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3678480290 Receives reassigned benefits from 78 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Coon Rapids, MN; Maple Grove, MN; Richfield, MN; Saint Paul, MN
O20230809001813 MN DME Supplier - Independently-Practicing Physical TherapistDME Supplier - Independently-Practicing Occupational Therapist 3678480290 Practice locations: Maple Grove, MN

Other NPIs with the same Medicare PAC ID 14

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 14

Other NPIs on the same Medicare enrollment 10

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Novacare Outpatient Rehab50 organizations share this tax ID, including this one
Part of
Select Medical Corporation

Other organizations with this tax ID 49

Organizations that report the same tax identification number in the National Provider Directory.

View all 49

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Ohiohealth Rehabilitation HospitalColumbus, OH, CCN 363037 Hospital 5% Or Greater Indirect Ownership Interest (100%) Jan 1, 2023
Helen M. Simpson Rehabilitation HospitalHarrisburg, PA, CCN 393056 Hospital 5% Or Greater Indirect Ownership Interest (60%) Dec 1, 2014

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1570665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758844800000",
    "number": "1366084402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4714 GETTYSBURG RD",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170554325",
            "telephone_number": "717-972-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16366 COUNTY ROAD 30",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553111207",
            "telephone_number": "763-559-0356",
            "fax_number": "763-559-5193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVACARE OUTPATIENT REHABILITATION EAST, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SELECT MEDICAL",
        "enumeration_date": "2019-10-10",
        "last_updated": "2025-09-26",
        "certification_date": "2025-09-26",
        "status": "A",
        "authorized_official_last_name": "DUGGAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "CHIEF LEGAL OFFICER",
        "authorized_official_telephone_number": "717-972-1100"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NovaCare Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Maple Grove, MN

Sources for this page

Verify at the official NPI Registry.