Individual provider Active NPI

Rachel Peterson, LPT

  • Physical Therapist
  • Coon Rapids, MN
National Provider Identifier
1376621169
Registry record updated Jun 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
7483 Issued in MN
Practice address
3833 Coon Rapids Blvd NW Ste 100
Coon Rapids, MN 55433-2697
Phone
(763) 427-8320
Fax
(763) 712-5429
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X
Physical Therapist 225100000X 7483 MN Primary

Addresses

Primary practice location

3833 Coon Rapids Blvd NW Ste 100
Coon Rapids, MN 55433-2697

Mailing address

3833 Coon Rapids Blvd NW Ste 100
Coon Rapids, MN 55433-2697
Phone (763) 427-8320

Other identifiers 1

IdentifierTypeStateIssuer
1376621169MedicaidMN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051102000385 MN Practitioner - Physical Therapist in Private Practice 9133146715 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Temple University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minneapolis Clinic of Neurology LTDGroup PAC ID 5496668659, 75 clinicians

Practice addresses (Care Compare)

3833 Coon Rapids Blvd NW
Suite 100
Coon Rapids, MN 55433-2697
Phone (763) 427-8320

Merit-based Incentive Payment System (MIPS)

Final score
92.39 of 100Reported as group
Quality
84.12
Promoting interoperability
100
Improvement activities
40
Cost
83.94

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7483MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Minneapolis Clinic of Neurology, LTD Physical Therapist CurrentSince May 17, 2016 Accepting new patients

Locations

3833 Coon Rapids Blvd NW
Ste 100
Minneapolis, MN 55433
Phone (763) 427-8320

4225 Golden Valley Rd
Minneapolis, MN 55422
Phone (612) 588-0661

Organizations & group practices 1

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559779200000",
    "number": "1376621169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3833 COON RAPIDS BLVD NW STE 100",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332697",
            "telephone_number": "763-427-8320",
            "fax_number": "763-712-5429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3833 COON RAPIDS BLVD NW STE 100",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332697",
            "telephone_number": "763-427-8320",
            "fax_number": "763-712-5429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "RACHEL",
        "credential": "LPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2019-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "7483",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1376621169",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coon Rapids, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2019; 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.