NPIMap

Organization Active NPI

Novacare Outpatient Rehabilitation East, Inc.

  • 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.
Practice address
16366 County Road 30
Maple Grove, MN 55311-1207
Phone
(763) 559-0356
Fax
(763) 559-5193
NPI assigned
Oct 10, 2019
Organization subpart
Yes
Parent organization
SELECT MEDICALAs reported in NPPES

Authorized official

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

Owned or controlled facilities with NPI records 2

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

Other NPIs on the same Medicare enrollment 10

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

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

Corporate family (same tax ID) 49

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

View all 49

Member organizations 62

Organizations listed as members of this organization in the National Provider Directory.

View all 62

Practitioners 500

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 500

Medicare participation

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

All facility ownership & control disclosures 2

Medicare enrollment files

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

Medicare enrollment records 2

Medicare enrollment files
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

National Provider Directory

National Provider Directory
Tax ID family
Novacare Outpatient Rehab E (50 organizations share this tax ID)
Part of
Select Medical Corporation

Locations

16366 County Road 30
Maple Grove, MN 55311
Phone (651) 203-4673

6605 Nicollet Ave
Richfield, MN 55423
Phone (612) 872-2700

Specialties & licenses 2

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

Addresses

NPPES NPI Registry

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

NPPES NPI Registry
  • NovaCare Rehabilitation Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 26, 2025.

{
    "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.