NPIMap

Organization Active NPI

Novacare Outpatient Rehabilitation East Inc

Doing business as NovaCare Rehabilitation

  • Physical Therapy Clinic/Center
  • Rogers, MN
National Provider Identifier
1609872522
Registry record updated Oct 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
NOVACARE OUTPATIENT REHABILITATION EAST INC
Doing business as
NovaCare Rehabilitation
Practice address
21395 John Milless Dr
Rogers, MN 55374-4402
Phone
(763) 428-2589
Fax
(763) 428-4672
NPI assigned
Jun 24, 2005
Last updated
Oct 21, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2025

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

Authorized official

Name
John F Duggan
Title
Vice President
Phone
(717) 972-1100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X MN Primary

Addresses

Primary practice location

21395 John Milless Dr
Rogers, MN 55374-4402

Mailing address

4714 Gettysburg Rd
Legal Department
Mechanicsburg, PA 17055-4325
Phone (717) 972-1100

Other names 1

  • NovaCare Rehabilitation Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050816000902 MN Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 3678480290 Practice locations: Blaine, MN; Coon Rapids, MN; Crystal, MN; Elk River, MN; Fridley, MN; Minnetonka, MN; Plymouth, MN; Rogers, MN
O20121228000194 MN Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3678480290 Receives reassigned benefits from 78 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Coon Rapids, MN; Maple Grove, MN; Richfield, MN; Saint Paul, MN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1609872522. Details of each certification follow.

  • CCN 246577 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 246577

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
NOVACARE OUTPATIENT REHABILITATION EAST INC
Certification status
Active
Provider type (POS)
Outpatient physical therapy / speech pathology
Participating since
Aug 23, 1996
Last certification
Apr 26, 2017
Ownership / control type
Proprietary
Most recent change of ownership
Jan 29, 1998
Facility address
21395 John Milless Drive
Rogers, MN 55374

Other NPIs with the same Medicare PAC ID 14

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 14

Other NPIs on the same Medicare enrollment 10

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

National Provider Directory

National Provider Directory

Locations

1387 Phalen Blvd
Saint Paul, MN 55106
Phone (952) 388-5520

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Ohiohealth Rehabilitation HospitalColumbus, OH, CCN 363037 Hospital 5% Or Greater Indirect Ownership Interest (100%) Jan 1, 2023
Helen M. Simpson Rehabilitation HospitalHarrisburg, PA, CCN 393056 Hospital 5% Or Greater Indirect Ownership Interest (60%) Dec 1, 2014

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1119571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761004800000",
    "number": "1609872522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4714 GETTYSBURG RD",
            "address_2": "LEGAL DEPARTMENT",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170554325",
            "telephone_number": "717-972-1100",
            "fax_number": "717-975-9981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21395 JOHN MILLESS DR",
            "city": "ROGERS",
            "state": "MN",
            "postal_code": "553744402",
            "telephone_number": "763-428-2589",
            "fax_number": "763-428-4672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVACARE OUTPATIENT REHABILITATION EAST INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-24",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A",
        "authorized_official_last_name": "DUGGAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "717-972-1100"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NovaCare Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rogers, MN

Sources for this page

Verify at the official NPI Registry.