NPIMap

Individual provider Active NPI

Peter David Aggen, DPT

  • Physical Therapist
  • Saint Paul, MN
National Provider Identifier
1376560706
Registry record updated Jun 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8147 Issued in MN
Practice address
30 Fairview Ave S Ste 200
Saint Paul, MN 55105-1463
Phone
(952) 835-4512
Fax
(888) 425-0398
NPI assigned
Jul 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2021

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 8147 MN Primary

Addresses

Primary practice location

30 Fairview Ave S Ste 200
Saint Paul, MN 55105-1463

Mailing address

7825 3Rd St N
Suite 105
Oakdale, MN 55128-5444
Phone (952) 835-4512

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130220000227 MN Practitioner - Physical Therapist in Private Practice 2860426129 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2004
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)

30 Fairview Ave S
Suite 200
Saint Paul, MN 55105-1463
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
8147MNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Infinite Health Collaborative, PA CurrentSince Jan 1, 2023 Accepting new patients
Infinite Health Collaborative, PA Physical Therapist CurrentSince Jan 1, 2023 Accepting new patients
Viverant, LLC Physical Therapist PastSince Jan 14, 2013 Accepting new patients
Gundersen Clinic LTD Past Accepting new patients
St. Croix Orthopaedics, PA Past Accepting new patients

Locations

6520 150th St W
Ste 100
Apple Valley, MN 55124

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

4200 Dahlberg Dr
Ste 300
Minneapolis, MN 55422
Phone (952) 512-5600

30 Fairview Ave S
#200
Saint Paul, MN 55105

3912 Excelsior Blvd
St Louis Park, MN 55416
Phone (528) 354-5129

Organizations & group practices 25

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.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623715200000",
    "number": "1376560706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7825 3RD ST N",
            "address_2": "SUITE 105",
            "city": "OAKDALE",
            "state": "MN",
            "postal_code": "551285444",
            "telephone_number": "952-835-4512",
            "fax_number": "888-425-0398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 FAIRVIEW AVE S STE 200",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551051463",
            "telephone_number": "952-835-4512",
            "fax_number": "888-425-0398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGGEN",
        "first_name": "PETER",
        "middle_name": "DAVID",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-15",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "8147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2021; 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.