Individual provider Active NPI

Jean-Paul Mbabazi Ndayizeye, DPT

  • Physical Therapist
  • Bloomington, MN
National Provider Identifier
1548978273
Registry record updated Nov 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
12780 Issued in MN
Practice address
4801 W 81St St Ste 112
Bloomington, MN 55437-1111
Phone
(952) 345-3000
Fax
(952) 345-6789
NPI assigned
Nov 11, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 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 12780 MN Primary

Addresses

Primary practice location

4801 W 81St St Ste 112
Bloomington, MN 55437-1111

Mailing address

4801 W 81St St Ste 112
Bloomington, MN 55437-1111
Phone (952) 345-3000

Other practice location 1

7650 Currell Blvd Ste 260
Woodbury, MN 55125-8209
Phone (952) 345-3000

Other practice location 2

162 Cobblestone Ln
Burnsville, MN 55337-4578
Phone (952) 345-3000

Other practice location 3

1630 101st Ave NE Ste 160
Blaine, MN 55449-3403
Phone (952) 345-3000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221125000198 MN Practitioner - Physical Therapist in Private Practice 7315315264 Reassigns benefits to 2 organizations

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
Minnesota Luna Care Physical Therapy LLCGroup PAC ID 6103230172, 36 clinicians

Practice addresses (Care Compare)

428 Minnesota St
Suite 500
Saint Paul, MN 55101-2666
Phone (866) 525-3175

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12780MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
National Dizzy & Balance Center,LTD. Physical Therapist CurrentSince Dec 1, 2022 Accepting new patients
Minnesota Luna Care Physical Therapy LLC Physical Therapist CurrentSince Sep 10, 2024 Accepting new patients

Locations

1630 101st Ave NE
Ste 160
Blaine, MN 55449
Phone (763) 786-6900

162 Cobblestone Ln
Burnsville, MN 55337
Phone (952) 345-3000

4801 W 81st St
Ste 112
Minneapolis, MN 55437
Phone (952) 345-3000

428 Minnesota St
Ste 500
Saint Paul, MN 55101
Phone (612) 662-9604

7650 Currell Blvd
Ste 260
Woodbury, MN 55125
Phone (952) 345-3000

Organizations & group practices 2

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": "1668124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668124800000",
    "number": "1548978273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 W 81ST ST STE 112",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554371111",
            "telephone_number": "952-345-3000",
            "fax_number": "952-345-6789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 W 81ST ST STE 112",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554371111",
            "telephone_number": "952-345-3000",
            "fax_number": "952-345-6789"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7650 Currell Blvd Ste 260",
            "address_purpose": "LOCATION",
            "city": "Woodbury",
            "state": "MN",
            "postal_code": "551258209",
            "country_code": "US",
            "telephone_number": "952-345-3000",
            "fax_number": "952-345-6789",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "162 Cobblestone Ln",
            "address_purpose": "LOCATION",
            "city": "Burnsville",
            "state": "MN",
            "postal_code": "553374578",
            "country_code": "US",
            "telephone_number": "952-345-3000",
            "fax_number": "952-345-6789",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1630 101st Ave NE Ste 160",
            "address_purpose": "LOCATION",
            "city": "Blaine",
            "state": "MN",
            "postal_code": "554493403",
            "country_code": "US",
            "telephone_number": "952-345-3000",
            "fax_number": "952-345-6789",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NDAYIZEYE",
        "first_name": "JEAN-PAUL",
        "middle_name": "MBABAZI",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-11",
        "last_updated": "2022-11-11",
        "certification_date": "2022-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "12780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 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.