Individual provider Active NPI

Madeline Sophie Scheunemann

  • Physical Therapist
  • Eagan, MN
National Provider Identifier
1417686734
Registry record updated Jun 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
12691 Issued in MN
Practice address
2620 Eagan Woods Dr Ste 240
Eagan, MN 55121-1138
Phone
(651) 968-5201
NPI assigned
Jun 10, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 12691 MN Primary

Addresses

Primary practice location

2620 Eagan Woods Dr Ste 240
Eagan, MN 55121-1138

Mailing address

710 Commerce Dr Ste 200
Woodbury, MN 55125-4925
Phone (651) 968-5201

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220628001084 MN Practitioner - Physical Therapist in Private Practice 9032598669 Reassigns benefits to 1 organization
I20260527000836 WA Practitioner - Physical Therapist in Private Practice 9032598669 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Orthopedics, LTDGroup PAC ID 8921900374, 282 clinicians
Apple Physical Therapy LLCGroup PAC ID 7810892072, 285 clinicians

Practice addresses (Care Compare)

2090 Woodwinds Dr
Woodbury, MN 55125-2522
Phone (651) 968-5201

25012 104TH Ave SE
Suite C
Kent, WA 98030-2821
Phone (253) 856-3477

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Orthopedics, LTD CurrentSince Jul 5, 2022 Accepting new patients
Summit Orthopedics LTD CurrentSince Jul 5, 2022 Accepting new patients
Ilbnc, P.a. PastSince Jun 12, 2022 Accepting new patients
Summit Orthopedics, LTD PastSince Jun 12, 2022 Accepting new patients

Locations

1661 Saint Anthony Ave
Saint Paul, MN 55104
Phone (651) 968-5300

710 Commerce Dr
Ste 200
Woodbury, MN 55125
Phone (651) 968-5042

2090 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 968-5801

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": "1654819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654819200000",
    "number": "1417686734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 COMMERCE DR STE 200",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551254925",
            "telephone_number": "651-968-5201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 EAGAN WOODS DR STE 240",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551211138",
            "telephone_number": "651-968-5201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHEUNEMANN",
        "first_name": "MADELINE",
        "middle_name": "SOPHIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-10",
        "last_updated": "2022-06-10",
        "certification_date": "2022-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "12691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.