Individual provider Active NPI

Darcy Ray Schubloom, PT

  • Physical Therapist
  • Roseville, MN
National Provider Identifier
1679672968
Registry record updated Feb 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4601 Issued in MN
Practice address
1955 County Road B2 W
Roseville, MN 55113-2723
Phone
(651) 697-1313
NPI assigned
Sep 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2012

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 4601 MN Primary

Addresses

Primary practice location

1955 County Road B2 W
Roseville, MN 55113-2723

Mailing address

5604 13TH Ave S
Minneapolis, MN 55417-2527

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120116000101 MN Practitioner - Physical Therapist in Private Practice 6103093133 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians

Practice addresses (Care Compare)

3400 W 66TH St
Suite 300
Edina, MN 55435-2110
Phone (952) 914-1965

717 Delaware St SE
Suite 340
Minneapolis, MN 55414-2959
Phone (612) 672-7422

Merit-based Incentive Payment System (MIPS)

Final score
88.63 of 100Reported as group
Quality
75.41
Promoting interoperability
100
Improvement activities
40
Cost
75.75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care CurrentSince Mar 1, 2020 Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Health Services CurrentSince Sep 1, 2000 Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Express Care CurrentSince Mar 1, 2020 Accepting new patients

Locations

15650 Cedar Ave
Ste 160
Apple Valley, MN 55124
Phone (952) 997-4170

14101 Fairview Dr
Ste 300
Burnsville, MN 55337
Phone (612) 273-5400

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

3400 W 66th St
Ste 290
Minneapolis, MN 55435
Phone (952) 836-3637

400 Stinson Blvd
Fl 2
Minneapolis, MN 55413
Phone (612) 672-2203

1955 County Road B2 W
Saint Paul, MN 55113
Phone (651) 635-0054

Organizations & group practices 6

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": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329782400000",
    "number": "1679672968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5604 13TH AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554172527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1955 COUNTY ROAD B2 W",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551132723",
            "telephone_number": "651-697-1313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHUBLOOM",
        "first_name": "DARCY",
        "middle_name": "RAY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2012-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "4601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Feb 21, 2012; 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.