NPIMap

Organization Active NPI

Rebound Orthotics & Prosthetics, Inc.

  • Prosthetic/Orthotic Supplier
  • Waconia, MN
National Provider Identifier
1376560722
Registry record updated Aug 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
REBOUND ORTHOTICS & PROSTHETICS, INC.
Practice address
582 Cherry Dr
Waconia, MN 55387-4578
Phone
(952) 442-3233
Fax
(952) 442-4959
NPI assigned
Jul 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2026

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

Authorized official

Name
Angela Dostal
Title
Administrator
Phone
(952) 442-3233

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X MN Primary

Addresses

Primary practice location

582 Cherry Dr
Waconia, MN 55387-4578

Mailing address

582 Cherry Dr
Waconia, MN 55387-4578
Phone (952) 442-3233

Other identifiers 2

IdentifierTypeStateIssuer
712670100MedicaidMN
73G91REOtherMNBCBS PROVIDER ID

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930068781 MN DME Supplier - Medical Supply Company With Orthotic-ProstheticDME Supplier - Medical Supply Company With Orthotic PersonnelDME Supplier - Medical Supply Company With Prosthetic PersonnelDME Supplier - Medical Supply Company With Pedorthic Personnel 5890903074 Practice locations: Waconia, MN

Other NPIs with the same Medicare PAC ID 3

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Rebound Orthotics & Prosthetics Inc582 Cherry Dr, Waconia, MN 55387-4578(952) 442-3233 Neuromuscular Elect Stimulators (NMES)/Supplies|Canes and/or Crutches|Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Limb Prostheses|Diabetic Shoes and Inserts|Diabetic Shoes/Inserts - Custom|Lymphedema Compression Treatment Items Does not accept assignmentParticipating since Jun 3, 2004

National Provider Directory

National Provider Directory
Tax ID family
Rebound Orthotics Prosthetics Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

2805 Campus Dr
Ste 101
Plymouth, MN 55441
Phone (612) 361-1000

NPI Registry JSON

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787097600000",
    "number": "1376560722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "582 CHERRY DR",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553874578",
            "telephone_number": "952-442-3233",
            "fax_number": "952-442-4959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "582 CHERRY DR",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553874578",
            "telephone_number": "952-442-3233",
            "fax_number": "952-442-4959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REBOUND ORTHOTICS & PROSTHETICS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-15",
        "last_updated": "2026-08-19",
        "certification_date": "2026-08-19",
        "status": "A",
        "authorized_official_last_name": "DOSTAL",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "952-442-3233"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "712670100",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER ID",
            "identifier": "73G91RE",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waconia, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2026; 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.