Individual provider Active NPI

Halley Rose Gluckman-Fine, PT

  • Physical Therapist
  • Lakeville, MN
National Provider Identifier
1366121584
Registry record updated Oct 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
13236 Issued in MN
Practice address
17811 Kenwood TRL
Lakeville, MN 55044-9493
Phone
(877) 609-0123
NPI assigned
Jul 14, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2025

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 13236 MN Primary

Addresses

Primary practice location

17811 Kenwood TRL
Lakeville, MN 55044-9493

Mailing address

PO Box 9188
Minneapolis, MN 55480-9188
Phone (952) 512-5600

Other names 1

  • Halley Fine Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230901001010 MN Practitioner - Physical Therapist in Private Practice 2264895655 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Pittsburgh School of Medicine, 2023
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)

17811 Kenwood TRL
Lakeville, MN 55044-9493
Phone (877) 609-0123

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
13236MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Infinite Health Collaborative, PA Physical Therapist CurrentSince Aug 14, 2023 Accepting new patients
Infinite Health Collaborative, PA CurrentSince Aug 14, 2023 Accepting new patients
Infinite Health Collaborative, PA PastSince Jul 16, 2023 Accepting new patients
St. Croix Orthopaedics, PA Past Accepting new patients

Locations

17811 Kenwood Trl
Lakeville, MN 55044

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

2678 149th St W
Rosemount, MN 55068

Organizations & group practices 4

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": "1689292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759449600000",
    "number": "1366121584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9188",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554809188",
            "telephone_number": "952-512-5600",
            "fax_number": "952-512-5651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17811 KENWOOD TRL",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550449493",
            "telephone_number": "877-609-0123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLUCKMAN-FINE",
        "first_name": "HALLEY",
        "middle_name": "ROSE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-14",
        "last_updated": "2025-10-03",
        "certification_date": "2025-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "13236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HALLEY",
            "last_name": "FINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lakeville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2025; 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.