Individual provider Active NPI

Brent Daniel Jorud, PT

  • Physical Therapist
  • Maplewood, MN
National Provider Identifier
1619064029
Registry record updated Aug 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6979 Issued in MN
Practice address
1655 Beam Ave
Suite 308
Maplewood, MN 55109-1163
Phone
(651) 439-8807
NPI assigned
Oct 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2016

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 6979 MN Primary

Addresses

Primary practice location

1655 Beam Ave
Suite 308
Maplewood, MN 55109-1163

Mailing address

4200 Dahlberg Dr
Suite 300
Golden Valley, MN 55422-4840
Phone (952) 512-5600

Other names 1

  • Brent Daniel Jorud Professional name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110228000899 MN Practitioner - Physical Therapist in Private Practice 4789865411 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Infinite Health Collaborative, PAGroup PAC ID 1052225042, 815 clinicians

Practice addresses (Care Compare)

3111 124TH Ave NW
Suite 200
Coon Rapids, MN 55433-4573
Phone (763) 427-7300

3545 Hwy 61 N
Vadnais Heights, MN 55110-5223
Phone (651) 439-8807

Merit-based Incentive Payment System (MIPS)

Final score
91.79 of 100Reported as group
Quality
95.08
Improvement activities
40
Cost
81.67

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6979MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Infinite Health Collaborative, PA CurrentSince Aug 15, 2016 Accepting new patients
Infinite Health Collaborative, PA Physical Therapist CurrentSince Aug 15, 2016 Accepting new patients
Infinite Health Collaborative, PA Past Accepting new patients

Locations

1655 Beam Ave
Ste 308
Maplewood, MN 55109
Phone (651) 770-7577

4200 Dahlberg Dr
Ste 300
Minneapolis, MN 55422
Phone (952) 512-5600

920 E 28th St
Ste 440
Minneapolis, MN 55407
Phone (612) 863-5155

Organizations & group practices 3

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": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471219200000",
    "number": "1619064029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 DAHLBERG DR",
            "address_2": "SUITE 300",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224840",
            "telephone_number": "952-512-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1655 BEAM AVE",
            "address_2": "SUITE 308",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091163",
            "telephone_number": "651-439-8807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORUD",
        "first_name": "BRENT",
        "middle_name": "DANIEL",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2016-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "6979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRENT",
            "last_name": "JORUD",
            "middle_name": "DANIEL",
            "credential": "PT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Maplewood, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2016; 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.