Individual provider Active NPI

Megan Pauly, DPT

  • Pediatric Rehabilitation Medicine Physician
  • Edina, MN
National Provider Identifier
1700417003
Registry record updated Jan 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Rehabilitation Medicine PhysicianTaxonomy code 2081P0010X
License
11547 Issued in MN
Practice address
3400 W 66TH St Ste 300
Edina, MN 55435-2110
Phone
(952) 924-1340
NPI assigned
Jan 27, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Rehabilitation Medicine Physician 2081P0010X 11547 MN Primary

Addresses

Primary practice location

3400 W 66TH St Ste 300
Edina, MN 55435-2110

Mailing address

5852 Russell Ave S
Minneapolis, MN 55410-2947

Other practice location 1

3305 Central Park Village Dr
Eagan, MN 55121-7707
Phone (651) 406-8868

Other practice location 2

150 Cobblestone Ln
Burnsville, MN 55337-4578
Phone (952) 460-4947

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1580083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580083200000",
    "number": "1700417003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5852 RUSSELL AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554102947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 W 66TH ST STE 300",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352110",
            "telephone_number": "952-924-1340"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3305 Central Park Village Dr",
            "address_purpose": "LOCATION",
            "city": "Eagan",
            "state": "MN",
            "postal_code": "551217707",
            "country_code": "US",
            "telephone_number": "651-406-8868",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "150 Cobblestone Ln",
            "address_purpose": "LOCATION",
            "city": "Burnsville",
            "state": "MN",
            "postal_code": "553374578",
            "country_code": "US",
            "telephone_number": "952-460-4947",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAULY",
        "first_name": "MEGAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-27",
        "last_updated": "2020-01-27",
        "certification_date": "2020-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine",
            "state": "MN",
            "license": "11547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.