Individual provider Active NPI

Marc Schultz, PT

  • Physical Therapist
  • Roseville, MN
National Provider Identifier
1417437880
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8042 Issued in MN
Practice address
2845 Hamline Ave N
Roseville, MN 55113-7127
Phone
(715) 294-0969
NPI assigned
Aug 15, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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 13260 WI
Physical Therapist 225100000X 8042 MN Primary

Addresses

Primary practice location

2845 Hamline Ave N
Roseville, MN 55113-7127

Mailing address

4401 Victoria St N
Shoreview, MN 55126-2226

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230105002794 MN Practitioner - Physical Therapist in Private Practice 9537539606 Reassigns benefits to 1 organization
I20230413001233 WI Practitioner - Physical Therapist in Private Practice 9537539606 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optage IncGroup PAC ID 2264619345, 61 clinicians

Practice addresses (Care Compare)

2945 Lincoln Dr
Roseville, MN 55113-1338
Phone (651) 631-6570

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13260WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Homes of Wisconsin, Inc. Physical Therapist CurrentSince Feb 1, 2023 Accepting new patients
Optage Inc Physical Therapist CurrentSince Oct 1, 2022 Accepting new patients
Optage Inc Physical Therapist CurrentSince Oct 1, 2022 Accepting new patients
Presbyterian Homes of Wisconsin, Inc. Physical Therapist CurrentSince Feb 1, 2023 Accepting new patients

Locations

2845 Hamline Ave N
Saint Paul, MN 55113
Phone (651) 631-6100

Organizations & group practices 4

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": "1534291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1417437880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 VICTORIA ST N",
            "city": "SHOREVIEW",
            "state": "MN",
            "postal_code": "551262226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2845 HAMLINE AVE N",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551137127",
            "telephone_number": "715-294-0969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHULTZ",
        "first_name": "MARC",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-15",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "13260",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "8042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2025; 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.