NPIMap

Organization Active NPI

Actra Rehabilitation Associates, Inc.

Doing business as NovaCare Prosthetics & Orthotics

  • Prosthetic/Orthotic Supplier
  • Roseville, MN
National Provider Identifier
1659346195
Registry record updated Oct 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
ACTRA REHABILITATION ASSOCIATES, INC.
Doing business as
NovaCare Prosthetics & Orthotics
Practice address
1891 County Road C W
Roseville, MN 55113-1304
Phone
(651) 645-9481
Fax
(651) 645-0944
NPI assigned
Feb 20, 2006
Last updated
Oct 20, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2025

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

Authorized official

Name
John Duggan
Title
Chief Legal Officer
Phone
(717) 972-1100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X Primary

Addresses

Primary practice location

1891 County Road C W
Roseville, MN 55113-1304

Mailing address

4714 Gettysburg Rd
Mechanicsburg, PA 17055-4325

Other identifiers 1

IdentifierTypeStateIssuer
41790000MedicaidMN

Other names 1

  • NovaCare Prosthetics & Orthotics Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930076042 MN DME Supplier - Medical Supply Company With Orthotic-ProstheticDME Supplier - Orthotic PersonnelDME Supplier - Prosthetic Personnel 1153448337 Practice locations: Roseville, MN

Other NPIs with the same Medicare PAC ID 3

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Novacare Prosthetics & Orthotics1891 County Road C W, Roseville, MN 55113-1304(651) 645-9481 Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Limb Prostheses|Diabetic Shoes and Inserts|Diabetic Shoes/Inserts - Custom|Lymphedema Compression Treatment Items Does not accept assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory
Tax ID family
Acme Laboratories5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

2032 Marshall Ave
Saint Paul, MN 55104

525 E Division St
Ste 104
Fond du Lac, WI 54935
Phone (920) 923-6676

1931 S Washburn St
Oshkosh, WI 54904
Phone (920) 426-1231

NPI Registry JSON

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

{
    "created_epoch": "1140393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760918400000",
    "number": "1659346195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4714 GETTYSBURG RD",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170554325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1891 COUNTY ROAD C W",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551131304",
            "telephone_number": "651-645-9481",
            "fax_number": "651-645-0944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTRA REHABILITATION ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-20",
        "last_updated": "2025-10-20",
        "certification_date": "2025-10-20",
        "status": "A",
        "authorized_official_last_name": "DUGGAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CHIEF LEGAL OFFICER",
        "authorized_official_telephone_number": "717-972-1100"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41790000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NovaCare Prosthetics & Orthotics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NovaCare Prosthetics & Orthotics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 20, 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.