Individual provider Active NPI

Stephanie Levasseur, PT, DPT

  • Physical Therapist
  • Saint Paul, MN
National Provider Identifier
1417323049
Registry record updated Oct 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
12880 Issued in MN
Practice address
2155 Ford Pkwy
Saint Paul, MN 55116-2799
Phone
(651) 696-5010
NPI assigned
Aug 18, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2022

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 42772 CA
Physical Therapist 225100000X 12880 MN Primary

Addresses

Primary practice location

2155 Ford Pkwy
Saint Paul, MN 55116-2799

Mailing address

17332 Von Karman Ave
Ste 120
Irvine, CA 92614-6282

Other practice location 1

12250 El Camino Real
Suite 190
San Diego, CA 92130-3076
Phone (858) 793-1460

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221028001068 MN Practitioner - Physical Therapist in Private Practice 4385952951 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians

Practice addresses (Care Compare)

717 Delaware St SE
Suite 340
Minneapolis, MN 55414-2959
Phone (612) 672-7422

Merit-based Incentive Payment System (MIPS)

Final score
88.63 of 100Reported as group
Quality
75.41
Promoting interoperability
100
Improvement activities
40
Cost
75.75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care Current Accepting new patients
Fairview Express Care CurrentSince Nov 19, 2022 Accepting new patients
Fairview Express Care CurrentSince Nov 19, 2022 Accepting new patients
JM Physical Therapy Inc Physical Therapist Past Accepting new patients
Fairview Health Services Past Accepting new patients

Locations

12000 Elm Creek Blvd N
Ste 120
Maple Grove, MN 55369
Phone (763) 420-9960

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

10961 Club West Pkwy
Ste 200
Minneapolis, MN 55449
Phone (763) 528-2922

1700 University Ave W
Saint Paul, MN 55104
Phone (612) 672-6740

2155 Ford Pkwy
Saint Paul, MN 55116
Phone (651) 696-5000

Organizations & group practices 5

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": "1439856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665705600000",
    "number": "1417323049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17332 VON KARMAN AVE",
            "address_2": "STE 120",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926146282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2155 FORD PKWY",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551162799",
            "telephone_number": "651-696-5010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12250 El Camino Real",
            "address_2": "Suite 190",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921303076",
            "country_code": "US",
            "telephone_number": "858-793-1460",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEVASSEUR",
        "first_name": "STEPHANIE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-18",
        "last_updated": "2022-10-14",
        "certification_date": "2022-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "42772",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "12880",
            "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 Oct 14, 2022; 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.