NPIMap

Organization Active NPI

Orthorehab Specialists, Inc.

  • Physical Therapist
  • Minneapolis, MN
National Provider Identifier
1396754206
Registry record updated Nov 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
ORTHOREHAB SPECIALISTS, INC.
Practice address
825 Nicollet Mall
Suite 1935
Minneapolis, MN 55402-2606
Phone
(612) 339-2041
Fax
(612) 339-2042
NPI assigned
Aug 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2013

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

Authorized official

Name
Mark W Siewert, PTNPI 1114982733
Title
Owner
Phone
(612) 339-2041

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X MN Primary

Addresses

Primary practice location

825 Nicollet Mall
Suite 1935
Minneapolis, MN 55402-2606

Mailing address

825 Nicollet Mall
Suite 1935
Minneapolis, MN 55402-2606
Phone (612) 339-2041

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031103000435 MN Part B Supplier - Clinic/Group Practice 3476465006 Receives reassigned benefits from 9 practitioners
1 other NPI on this enrollment
Practice locations: Edina, MN; Minneapolis, MN

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Orthorehab Specialists Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

825 Nicollet Mall
Ste 1935
Minneapolis, MN 55402
Phone (612) 339-2041

Practitioners & affiliated clinicians

Practitioners 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384473600000",
    "number": "1396754206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 NICOLLET MALL",
            "address_2": "SUITE 1935",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554022606",
            "telephone_number": "612-339-2041",
            "fax_number": "612-339-2042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 NICOLLET MALL",
            "address_2": "SUITE 1935",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554022606",
            "telephone_number": "612-339-2041",
            "fax_number": "612-339-2042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOREHAB SPECIALISTS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-07",
        "last_updated": "2013-11-15",
        "status": "A",
        "authorized_official_last_name": "SIEWERT",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-339-2041",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.